The messy work of upgrading parts of Hope House of the St. Croix Valley — a home for four people who have HIV/AIDS — is already underway. New flooring and cabinets will soon be installed, and the home was recently repainted. Come summer, a grassy plot along the side of the house will become a garden.

However, the organization’s three-year strategic plan is aimed at expanding beyond the blue-and-white Colonial in Stillwater.

Effective antiretroviral treatments have meant that those living with HIV/AIDS are living longer and more independent lives, said Bill Tiedemann, Hope House’s executive director.

“Individuals with HIV now have to worry about that aging thing that you and I have to worry about,” Tiedemann said. “So now for [Hope House] it’s about how we can help them age in place with dignity and compassion and how we can take our mission outside the house’s walls.”

Of the more than 8,700 people with HIV in Minnesota in 2017, nearly half were over the age of 50, according to the state Health Department.

“We are going to see a huge amount of people coming into the services system needing assistance with aging and HIV,” Tiedemann said.

During the next three years, Hope House plans to develop programs and services that allow people with HIV to age in their homes. The strategic plan also outlines goals of participating in research to better understand the needs of those with HIV as they age and develop ways to educate other providers on how best to serve that population.

“To be honest, 25 years ago, we never thought we’d ever be here, talking about these issues,” Tiedemann said.

Conversations about HIV and aging have slowly been building in recent years, said Dr. Nicholas Vogenthaler, medical director of the Hennepin Healthcare Positive Care Center.

“In many ways, I think some of the most pressing needs are similar to what other individuals face as they are getting older,” Vogenthaler said. Still, he added, having services specifically for those with HIV/AIDS may fill needs that more generalized programs wouldn’t.

Hope House was founded in 1991 by two St. Croix Valley residents. The organization bought a 2,600-square-foot house from St. Mary’s Catholic Church and moved it to a lot on the corner of North Everett and Cherry streets. The first resident moved in 1993. Since then, 86 people have stayed at the home, which is a licensed adult foster care facility.

Most of the residents had other health concerns preventing them from being able to live independently, such as diabetes, mental illness or a history or substance abuse.

“This becomes their home and their family,” said Kat Hill, the home’s care director.

Over the years, Hope House has become a permanent residence for those who come to stay. Three of the four current residents have lived there for several years. Due to a state moratorium on corporate adult foster care licenses, Hope House wouldn’t be able to open another similar facility.

“We are full, but we are finding at least three to 10 people come across our desk annually who are in need of our services,” Tiedemann said. “Because we don’t have room, we couldn’t serve them. That’s really why we wanted to do more.”

For Tony Ruzsa, a resident for nearly a decade, Hope House has been a source of stability and support.

“If I weren’t here, I’m not sure I’d be alive,” the 55-year-old said. “It’s a good place for people who need to overcome something they struggle with.”

Ruzsa, who has struggled with alcoholism, now works at Walmart and said he often thinks about the possibility of living by himself again. He’d likely need the kinds of services Hope House has outlined in its strategic plan.

“There definitely is a need for that,” Ruzsa said. “It’s a great idea.”

For Damon, 42, Hope House has provided both camaraderie and a sense of independence. (He withheld his last name to steer clear of his former associates.) After playing cards with the staff and other residents, he can retreat to his room, which he’s decorated with his artwork.

In one corner hangs a photo of a grinning Damon when he was 10 or 11 years old, holding up a massive walleye. That fishing trip came just a few years before he first tried heroin and about seven years before he was diagnosed with HIV.

“I’m very thankful for this place,” he said as he looked at a dream catcher hanging above his couch. He’s stayed clean and landed a part-time job since moving in. But above all, Damon said, Hope House has provided a place free of stigma.

Offering a nonjudgmental space for care and support has been the mission since the organization’s inception, Tiedemann said.

“Now we just want to do more with it.”