Living With HIV: It’s Not a Death Sentence in 2016

This update on living with HIV continues our previous interview with Rebecca Dillingham, MD, who works in the UVA Ryan White HIV Clinic. 

What’s different in HIV/AIDS today vs. 20 years ago? “If you do become infected, with appropriate treatment, a person living with HIV in 2016 can expect to live a normal lifespan. But the most important message is it’s no longer a death sentence,” Dillingham says.

Indeed, for those of us who grew up in the 1980s, the current statistics are astounding:

• The average lifespan of a person without HIV is 79 years.
• The average lifespan of a person with HIV diagnosed at age 20 taking current HIV medicines is 71 years.
• The average lifespan of a person with HIV diagnosed at age 20 not taking current HIV medicines is 32 years.

Clearly, with medication, antiretroviral therapy (ART), people are living longer with HIV.

Staying Healthy With HIV

Dillingham explains that patients with HIV need to pay attention to maintaining their health in the same way anyone with a chronic disease or taking medications over a long period of time should.

But her recommendations for people with HIV — about quitting smoking, getting cancer screenings, having a healthy weight — could apply to anyone. Issues arise, ironically, because many patients are “living with HIV and maybe didn’t expect to.”

The Necessity of Healthcare Access

Pricey & Necessary Meds

One aspect that can’t be overlooked, Dillingham notes, is that people with HIV need to have continued access to healthcare and health insurance. “Medication is still expensive,” she says, “between $15,000 and $30,000 a year.” State and federal programs exist that assist people living with HIV to access medications consistently. Here in Virginia, “a strong program that has successfully navigated the challenges of providing treatment in a changing healthcare landscape means that cost is rarely an issue for those being treated.”

Complex Issues With Other Conditions

Healthcare management plays a critical role when patients undergo surgeries and procedures for other conditions. That requires “coordination and good partnerships across clinical departments. We have a wonderful pharmacist in our clinic who helps make sure that patients have an uninterrupted supply of medication and can manage different medications. It takes that kind of specialized care for people with HIV to have an opportunity for a full lifespan.”

HIV Stats, Tests & PrEP

Prince Harry made his HIV test public for a reason: People who are infected and don’t know it live shorter lives and can spread the disease. Learn more about infection rates and the importance of testing and PrEP.

Having a Baby

Continued healthcare is also crucial for people wanting to have kids.

Living with HIV doesn’t necessarily mean a person can’t have children; but extra precautions must be taken. “We’re really lucky and have worked hard to provide full reproductive health services at the Ryan White Clinic,” Dillingham explains. “Our clinic collaborates with a terrific gynecologic nurse practitioner. This NP counsels couples who are hoping to conceive. With planning, reproductive goals can be met. We’ve had many babies born to women who follow regularly in our clinic; none of them have been HIV-positive.”

For women who are HIV-positive, following recommended guidelines can reduce the chance of transmission to the infant to near zero. With appropriate care, women living with HIV can carry their own infants.

And, says Dillingham, “We coach couples on the best strategies to minimize exposure. This way they can safely conceive without risk of transmission.” This means taking PrEP to reduce one partner’s viral load to a point at which the virus is undetectable, thus preventing the spread of the disease.

HIV Healthcare Going Forward

Overall, Dillingham feels privileged to work with her team at UVA.

“We are a busy clinic, with 700 active patients and 50 new clients a year. Our team follows an inclusive strategy that makes people feel welcome and cared for,” she says.

But that’s the world within the clinic. Dillingham’s main concern for her patients regards the continued stigma and ignorance out in the world that can prevent people from getting tested or treated.

Living With HIV?

Get care at the Ryan White HIV Clinic.

Dillingham hopes everyone can learn to think about HIV the way they would about any chronic disease. “Maybe like cancer, which was once unspeakable,” she suggests. “I look forward to the time when people living with HIV will be able to feel more comfortable talking about their condition. And, when people living with HIV do decide to share, I hope that they will gain support and compassion from others. I hope that all people will begin to see people living with HIV really living and thriving.”