I took the rapid HIV test 15-some times in Philadelphia before I tested positive. The test takes about 20 minutes from when the nurse punctures your finger (with negligible pain) to when you get your results. Each of those 20 minutes were the longest of my life, not because I was aware of what my medical life would entail if I tested positive, but because I was too occupied envisioning the complete and utter collapse of my social and love life.
When I did test positive, however, I was jolted by the information overload I received from the doctors and social workers. The most terrifying element of it all was what one young social worker said to me: “While we want to help you live a healthy, happy life, the choice is yours as to whether or not you come back and see us. You can walk right out that door and never come back again, if you choose.”
“How many people never return?” I asked.
And she said, “More than you think.”
When you discover you’re positive — or poz — the initial shock can last anywhere from two weeks to a year, according to various testimonies. During that time, seeking help, both emotionally and medically, is paramount to managing the virus and making good choices: The temptation to ignore your new sero-status is more attractive than you would think.
Let’s be honest: Every doctor, social worker and therapist will have different, if not vastly contrasting, perspectives on post-poz care; meaning, that all the options for medication, therapy, matters of public and private disclosure and sexual activity henceforth is ultimately up to you.
For the sake of discussion, I’ll outline an HIV treatment regimen that most doctors would agree is the safest and healthiest option available:
Doctor visits every three months for blood tests and check-ups; taking medication; no smoking; eating healthy and exercising regularly; attending regular therapy sessions; disclosing one’s status to family and friends and before any type of sexual activity; and always using condoms (even during oral sex).
With this model, you would receive constant audits of your viral load (the particles-per-million of the virus present in your blood), your T-cell count (white blood cells that play an essential role in bodily immunity), eventually becoming undetectable (aka possessing an infinitesimal viral load), staying in good health, having a group of people aware of your status, getting immediate reactions from potential sexual and/or romantic partners, as well as reducing the risk of transmission to its nadir.
Now, while this model seems optimal, not everyone is as keen on disclosing their status outright, nor has the easiest time eating healthy or exercising regularly or, more importantly, using condoms. This model also assumes that the poz person in question has a supportive family and/or group of friends, or that they even have the gumption for disclosure.
I’m lucky that I’ve already developed healthy exercising and eating habits (save the occasional cheesesteak — when in Rome, right?), my friends and family are loving and educated on HIV and I have a naturally healthy immune system. However, while I always disclose my status (which is never easy), I don’t typically use condoms when having intercourse with other HIV-poz men, and have had my foray into various drug use (methamphetamines included) that has facilitated unsafe behavior — at times, when HIV negative men were involved, knowing others were poz and unconcerned with the consequences after the fact.
Such activity obviously not only puts HIV-neg people at risk, but myself as well. Just because you’re poz doesn’t mean you can’t contract another strain of the virus, or — even worse — a super-infection, a highly resistant strain of the virus immune to most available medications.
HIV’s DNA is sloppy: It reacts differently to each person, as well as to various forms of medication and one’s susceptibility for transmission. HIV treatment, then, doesn’t solely concern HIV-poz folk, but the uninfected as well.
So, what can you do, despite the extant temptations to ignore your sero-status, to ensure a life led in sound mental and bodily health? My answer: Talk about it. A lot. Talk with doctors. Talk with social workers. Talk with your family and friends. And if disclosure is an issue for you, attend support groups at any of the HIV-care facilities available in Philadelphia. There’s also a great website called thebody.com, which offers a bounty of information concerning HIV, in addition to articles by HIV columnists, like myself, who write about the subject prolifically.
There are no debating schools of thought about dialoguing about HIV. It’s the best prevention and treatment plan around and should therefore be applied liberally.
Aaron Stella is editor-in-chief of Phillybroadcaster (www.phillybroadcaster.com), an all-inclusive A&E city blog site in Philadelphia. Since graduating from Temple University with a bachelor’s in English, he has written for several publications in the city, and now devotes his life to tackling the new challenges of HIV in the 21st century.