A Leader in Care for LGBTQ+ Communities: Meet Kenneth Abriola, MD

A Leader in Care for LGBTQ+ Communities: Meet Kenneth Abriola, MD

By Jane Latus

Kenneth Abriola, MD, has been treating people with infectious diseases in Greater Hartford for more than 30 years. It’s no exaggeration to call him a local legend in the field of HIV medicine and in the LGBTQ+ community. Get to know him a little, and you’ll know why.

He battled through the worst of the AIDS crisis, first as a medical student in the late 1980s, volunteering for the Hartford Gay & Lesbian Health Collective (HGLHC, now called The Health Collective). After completing his medical training in New Orleans, he returned to Hartford in 1993 as director of the AIDS program at the Mt. Sinai Hospital Burgdorf Clinic. He then became assistant director of the AIDS program at Hartford Hospital. While practicing full-time, he also volunteered as medical director of the HGLHC for about 30 years. He went into private practice in 2004, specializing in LGBTQ+ primary care, and in 2023 merged his practice with Circle Care Center, which provides primary care, HIV prevention, sexual health management and gender affirming care. He is now Circle Care’s medical director and volunteers to educate nursing and medical students in LGBTQ+ care.

He lives in Moodus with his partner George Teran and their two Golden Retrievers.

Before getting to our questions for him, there are some key things to know about Abriola.

While an undergrad at Boston College, he went on a medical mission to Haiti that inspired his life-long interest in tropical disease. After UConn Medical School and then a residency at St. Francis Hospital, he went in 1991 to Tulane University Medical Center for his fellowship year. Tulane had a Master of Public Health and Tropical Medicine program that interested him, and at the time he envisioned himself in a Doctors Without Borders sort of career.

His plans changed while at Tulane, where his clinical responsibility was in its AIDS unit.

“We were managing and treating opportunistic infections, but most of the time it was a losing battle. We couldn’t fix the immune system. So, they’d succumb to one thing after another. That was a change for me. I turned away from tropical diseases,” he says. “Men having sex with men–that was my community.” 

The same curiosity and knack for detective work that interested him in infectious disease in general was especially handy when treating HIV. “Infectious disease doctors don’t really have ‘a procedure; ’ our procedure is the questions we ask,” Abriola says. When there was no medical means to block HIV transmission or prevent AIDS, they had to investigate and improvise. “There was so much learning around it, coming up with treatment strategies.”

A former colleague points out two more traits that make Abriola an outstanding doctor: kindness, and intolerance for anything less than a diligent effort on patients’ behalf. 

Anne Duncan of Canton worked with him for most of the 1990s in the AIDS clinic at Trinity Hill Nursing Home in Hartford (now the Trinity Hill Care Center). Duncan was a counselor, and Abriola worked at the clinic as part of a cooperative agreement with Mt. Sinai Hospital.

“It was a very hard job” and a tight, highly functioning team, says Duncan. “Ken is one of the nicest people that I know and has a heart beyond beautiful.” As a doctor, she says, “He was lovely. He was gentle.” Duncan recalls an AIDS patient picking up her guitar and bursting into, “Wild thing, you make my heart sing,” as Abriola walked into her room.

“He said to me, ‘Is she singing about me?’ I said, ‘Of course she is! Pay attention!’”

Duncan also recalls, “He had a temper, but it was only at things he absolutely should have been mad about,” like errors or incompetence. She recalls him throwing a pencil so hard that it smashed a window.” (Says Abriola: “I definitely have a reputation for having a temper. I’m not in the least bit proud of it.”)

Perhaps the best testimonial to him as a doctor is that most of his patients have stuck with him for decades. One man, who has full-blown AIDS, has been with him 30 years.

How do you explain to those who were born later what the AIDS crisis was like? 

We have a whole generation of young adults who weren’t alive for 9/11 and don’t realize what it was like and what it meant to the country. People my age in general probably know a friend or acquaintance who passed from HIV. I can think of several of my high school friends who passed away. I don’t think Pearl Harbor impacted me the way it did my parents.

Back in 1991 when you started caring for AIDS patients at Tulane, did you ever think the day would come when HIV could be kept in check and AIDS prevented?

There’s been a sea change in HIV. Vaccine strategies are still 10 years away.  It’s always 10 years away. But I’m so excited about everything we have done. It would be amazing to get to a vaccine. But to think where we were–that people would give up because the medications were so hard to use–and now with one pill a day you can sail along with no infection …. 

What did care consist of in your earliest years of practice? 

It was a very hard time. In the window when some treatments started to become available, there were definitely success stories. There were folks who’d come in with end-stage AIDS, and you’d support them. We ran the gamut from implementing the most aggressive care possible for some people, and for other people realizing we had to focus on helping them to have a good death.

1991 to 1996 were years we weren’t so good at treatment. It was at a 1996 conference when the first combination of therapies came out that were finally blocking HIV replication.

We went from having no good therapies to those that were potentially helpful, and I say potentially because you needed multiple pills, multiple times a day, and not everyone could handle it.

How did you manage to cope?

Humor’s good medicine. Especially at Trinity Hill, where we had a really hard-working team, we’d find the humor in a situation. We had one guy who was deteriorating, and Anne Duncan walks into the room to check on him, and he opens his eyes and says, “Not dead yet. Only sleeping.” Other times, certain things would push my buttons. I remember going to see the movie where Tom Hanks plays a man with AIDS. Watching this movie, I was sobbing uncontrollably. There were these moments when unexpected releases of raw emotion would just overwhelm you.

What made you angry? 

I don’t have patience for mediocrity, even now. I used to get so angry when you’d see a patient deteriorate again. You could send someone home and six to eight months later they’re back. At Trinity Hill, they were getting help with this complex regimen. You’d see them again, and they’d lost weight and were having fevers and night sweats again. Maybe they couldn’t handle the regimen. Maybe they were discharged to a less-than-optimal housing situation, or they relapsed into substance abuse. Things got in the way of their ability to stay well. That was very frustrating. I used to call it the revolving door. The system was the problem. [I would say] I can give you these meds, but you need a warm, dry place to keep them. There were just all these moving parts to keep people well. Sometimes you’d just blow. 

What about the political side? Were you angry at the government for ignoring AIDS?

Thank God activists were doing their part while I was doing mine.

What now concerns you most about HIV transmission?

Now there are still more infections among men having sex with men (MSM) than any other group. But there’s also this tragic situation where the greatest rates of transmission among MSM are men of color. The greatest uptake of pre-exposure prophylaxis [PrEP] is among white MSM, but the greatest risk is among men of color who are also MSM.

Do you know why?

It’s multifactorial. You have to be educated that pre-exposure prophylaxis exists. If you aren’t out, if you’re living down low, you may not have the connections to know about it. There are cultural and economic factors.

There’s a newer HIV prevention that’s a 60-day injection, but it’s hard to get. That would be a great tool for people who don’t want a pill bottle in their house for other people to see.

What’s the current state of HIV treatment?

I’m not worried anymore about opportunistic infections, which is a wonderful thing. HIV causes inflammation, and people with HIV have twice the risk of heart disease than those who are HIV negative. So now I’m telling patients, your HIV is undetectable but let’s talk about your cholesterol. Women with HIV are at greater risk for cervical cancer.

What infectious diseases are now most problematic?

STIs. The management of HIV cuts both ways. When you can no longer expose your partner to HIV, the consequence is a decline in condom use. Syphilis is an epidemic now in MSM. We’re even seeing neonatal cases now, and it’s impacting nearly every age group.

In 2022, I was involved in diagnosis and treatment of Mpox, and helped dispense the vaccine at the Health Collective and Circle Care. It slowed down, though there was a slight uptick in 2024, and it’s still circulating.

We talk with everyone about PrEP. We discuss patients’ whole health, Mpox, HPV, hepatitis and meningitis. There’s a kind of meningitis that’s spread by close personal contact so crowding, like large parties, is a risk. The Meningitis B vaccine has some cross-protection against gonorrhea, so we encourage that.

Anyone who has receptive anal sex, even HIV negative people, should be screened after age 45 for anal cancer.

What worries you most about the future under an anti-science government?

There’s been an evolving vaccine hesitation even before the current administration, which is why we’re seeing things like the measles outbreak. The administration is an exacerbation. I’m all for prevention, so resistance makes me sad. It’s not new historically; there was smallpox vaccination hesitancy in the 1700s. I think some damage will be done.

How can you convince people to have faith in vaccines?

It’s partly a leadership problem but also an educational problem. You need to get the right message out. Vaccines aren’t perfect, but aspirin isn’t either.

What do you see in your future?

I really like what I do. The merger with Circle Care infused new life into me. I don’t have to work weekends at hospitals, and I’m working full-time but have the chance to enrich myself. I recertified my infectious disease boards and am now working on my internal medicine boards. I also recertified as an American Academy of HIV Medicine HIV specialist. You don’t go through all that pain and think about retiring!

Looking back, what are you most proud of? 

I was very proud to be a part of a team tackling HIV care in the Greater Hartford area. I have to emphasize “team”.

These days, what about your work is most satisfying?

There are just these moments when I realize: oh, I nailed that! I have a young man with AIDS who was having unexplained fevers and night sweats. First, you look for the typical opportunistic infections, and nothing’s coming up. You have to go back to basics. Who have you lived with, did you travel, what did you eat, who have you had sex with? Do you have any pets? Does your cat ever scratch you? Oh my God, it was Bartonella, cat scratch fever. That’s what infectious disease doctors do!