For many Americans, the AIDS epidemic that began in the 1980s is now a fading memory of a tragic period in social and medical history. But it still impacts the career of Dr. Shelley Gilroy, who was one of the physicians on the front lines when the mysterious, frightening disease began its rampage across the nation, part of a global pandemic. “We lost a lot of patients,” recalls Dr. Gilroy, an internal medicine specialist. “It was so sad because there weren’t any effective treatments to offer at that time.”
The U.S. Centers for Disease Control and Prevention first documented Acquired Immune Deficiency Disorder, or AIDS, in June 1982. At first, it was diagnosed mostly among gay men and intravenous drug users. Then — in a fast, terrifying sweep — cases began to spring up among Americans from all walks of life, from hospital patients who’d received transfusions of tainted blood to seniors, mothers, and babies. Hundreds of thousands died. The CDC estimates that at least 600,000 men, women, and children infected with HIV — the virus that causes AIDS — have succumbed to HIV/AIDS since the disease first reached the United States, although in recent years it has stabilized, with about 50,000 new HIV infections each year.
“It was very challenging,” says Dr. Gilroy, who specializes in prevention and treatment of HIV and AIDS-related conditions. She did her internship and residency at Methodist Hospital in Brooklyn, and later worked at Lincoln and Metropolitan hospitals in Manhattan at the height of the AIDS crisis. She completed her fellowship in infectious diseases at New York Medical College at Lincoln and Metropolitan hospitals and at Westchester Medical Center.
Some drugs, such as AZT — approved by the U.S. Food and Drug Administration in 1986 — eventually came on the market and offered new hope, but the ravages of AIDS continued to spread. Dr. Gilroy recalls: “Between the time I started my medical fellowship at New York Medical College in 1988, and when I left in 1990, all the patients I had been taking care of had died, and a new group of AIDS patients was still coming in.”
Dr. Gilroy first grew interested in infectious diseases while studying at medical school in Guadalajara, Mexico. “I saw a lot of parasite infectious tuberculosis, but what clinched it was the AIDS epidemic. Then, by the time I came back to the U.S., the first cases of AIDS were starting to show up here, too,” she says.
By the mid- to late 1990s, treatment options were improving, and the number of AIDS/HIV cases in the U.S. started to level off. “It’s been much better ever since,” said Dr. Gilroy, who is affiliated with the Department of Medicine’s Division of Infectious Diseases at Albany Medical Center. She and her husband, Dr. Reid Muller, a cardiologist, live in Colonie.
“Fortunately, the majority of HIV patients are now doing well and living normal lives, as long as they take their medication every day,” Dr. Gilroy says.
Still, the threat of the HIV virus and other infectious diseases hasn’t disappeared. “Some people seem to think it’s just not going to happen to them. Or else they’re just not as afraid of HIV and other infections as people used to be.”
Statistically speaking, “We’re seeing an increase in rates of sexually transmitted infections, such as syphilis, in parts of the state,” she says. (The New York State Health Department reported a startling 30 percent hike in syphilis outside of New York City in 2013, with an increase in both urban and rural areas statewide.)
In addition to treating patients, Dr. Gilroy serves as an associate professor of medicine at Albany Medical College. “I had a lot of experience with HIV back in the ’80s,” she says, “and I want to pass that experience and information on to the new healthcare providers who will be graduating and out in private practice. Hopefully, it will help them diagnose and treat it early.”
Treatment breakthroughs
The CDC says that at least 1.1 million Americans are dealing with HIV infection today. Although no cure for the virus has yet been found, standard treatment nowadays usually involves a cocktail of medications. The Food and Drug Administration has approved more than 25 antiretroviral drugs to treat HIV, and the U.S. Department of Health and Human Services guidelines recommend that most patients start treatment with a regimen of three or more medicines from at least two different drug classes. “Patients used to have to take multiple pills, but now there are some treatments available that are a combination of several medications in one, so it’s easier for people to stick to taking their meds,” explains Dr. Gilroy. “These drugs are very expensive and are not without side effects like nausea, vomiting, diarrhea, rash, headaches, and even worsening of depression. There can also be interaction with other drugs.” The possibility of a vaccine is also getting closer. “That, and injectable medications — where a patient might only have to take it once a month or every three months — also look promising,” she says.
What everyone needs to know
Dr. Gilroy is concerned that some people, especially the older population, think that sexually transmitted diseases aren’t going to happen to them. “They think that if a person looks healthy, they surely don’t have HIV, and they don’t assume that people over 70 are sexually active. But you do have to think about HIV. We’re trying to get the word out to everyone, including the older population, to take precautions. And we recommend that everyone be tested for HIV.”
