While having sex with a guy I'd met through the web last week, he caught a mole on my back and I told him my status, which then initiated a huge panic about whether or not I'd exposed him to the virus. I felt an enormous surge of guilt that I'd not said from the beginning or that I'd not just gone with positive guys like I had considered before. Looking back on the experience, though, I think that rather than prompting me to go all out and tell everyone I meet that I am infected and thus infectious, that I'll stop telling people. This may sound callous and dangerous, but I will tell people instead that my status isn't known, that I haven't tested for a long time so can't say I'm sure about my status. In addition I will take extra cautious about making sure I don't expose other people to risk of transmission.
As I said before, I don't think I want to start choosing partners on the basis of their serostatus because that feels unnecessarily leper colony and distinctly punitive, something I want to avoid quite keenly. I am, however, going to start looking into getting moles and skin tags removed because they do present a risk of bleeding during encounters with other people and, as such, I should really try to minimise that risk. It means telling my GP, which I'm not keen on doing right now, but I might wait until I've had my next clinic appointment with a doctor there who can tell me if that's a sensible precaution to take.
The idea that I'm even considering having parts of my body removed as a result of this infection is something that repulses me, but the annoyance of them being caught and the risk that poses to other people bothers me more, I think.
Monday, September 26, 2005
Saturday, September 17, 2005
Serosorting and the Trouble with Numbers
Okay, so the safety in numbers approach really isn't working out so well. I'd thought that by making HIV a mathematical problem that could be dealt with in terms of prognosis and flowcharts would make it all make more sense - or any sense at all, if I'm honest - but I'm realising the dangers that come with it. First of all, it's perverse knowing the CD4 counts of loads of my friends and swallowing the sad knot in my throat when one guy was complaining that his count dropped by 40 since his last test. His lower result is still twice mine. If I continue using CD4 count and Viral Load as measures for health then I know I will go insane, if there's not already a danger of me heading that way anyway. There'll always be people with more, always people with less. I need to step back from that and actually look at the non-numeric side of it and stop feeling like I'm counting the grains in the hourglass. I'm healthy. Hell, I'm in damn good shape right now, if nightclub attention is any measure of bodily health.
One thing I'm noticing in myself though, probably a manifestation of toxicity anxiety, is that I'm really wary of sex with guys whose HIV status I don't know. Actually, that's not entirely it, I'm cruising guys and in my mind I'm making judgements about their HIV status without any basis in fact - looking for Antiretroviral side-effects, lipodystrophy and such like on the grounds that I couldn't bear the thought of infecting someone. Not that I'm planning on barebacking, even if there's no evidence to substantiate the dogma about re-infection making you more HIV+ than you were before, somehow, but just because it's a done deal.
I recognise, though, that serosorting without knowing for sure that someone is positive presents a real danger. If, say, I have it in my mind from someone's behaviour that they're probably positive, say, from comments they make that I interpret in a certain way, or if they push their arse against my cock without mentioning condoms, then I'm much more prone, particularly if I'm drunk or high or just depressed, to fuck without condoms. This would be a bad idea for several reasons.
If I'm assuming people are positive, I may well be wrong in my judgement, their comments could have been about something else, or their pressing themselves against me could be an incitement to fuck but with the assumption that I'm negative, or with them placing the responsibility for safe sex with the guy fucking.
If it's the other way around and they're fucking me, it might be that they don't think you're likely to catch HIV from being a top, because literature says the danger is from getting fucked without a condom, rather than pointing out that it works both ways, so they'll assume that I know they're negative and think it's fine that they fuck me.
Unprotected sex is just that and it's not like both being positive makes you immune to other infections or problems - I think that people assume that because HIV is demonised so much it's the worst case scenario, so fuck it, what is there to lose, you're already positive. The mathematics of how having the clap messes with your CD4 count aside, a dripping cock and green stains in your calvins really don't make for a good way of life.
Of course, the biggest and most important factor making me think I should not get into barebacking is, well, the shit-cock thing. I'm not sure I'd suck someone's cock straight after they've been barebacking someone - scat really isn't my scene - and getting shit on your cock is not really something likely to inspire passion in anyone.
So, for now, it's another trip to the clinic to pick up a carrier bag full of condoms, I think, and stop getting tempted by the supposedly increased intimacy of barebacking and think seriously about the clap and shitcock as good reasons to play safe as much as not wanting to transmit HIV.
One thing I'm noticing in myself though, probably a manifestation of toxicity anxiety, is that I'm really wary of sex with guys whose HIV status I don't know. Actually, that's not entirely it, I'm cruising guys and in my mind I'm making judgements about their HIV status without any basis in fact - looking for Antiretroviral side-effects, lipodystrophy and such like on the grounds that I couldn't bear the thought of infecting someone. Not that I'm planning on barebacking, even if there's no evidence to substantiate the dogma about re-infection making you more HIV+ than you were before, somehow, but just because it's a done deal.
I recognise, though, that serosorting without knowing for sure that someone is positive presents a real danger. If, say, I have it in my mind from someone's behaviour that they're probably positive, say, from comments they make that I interpret in a certain way, or if they push their arse against my cock without mentioning condoms, then I'm much more prone, particularly if I'm drunk or high or just depressed, to fuck without condoms. This would be a bad idea for several reasons.
If I'm assuming people are positive, I may well be wrong in my judgement, their comments could have been about something else, or their pressing themselves against me could be an incitement to fuck but with the assumption that I'm negative, or with them placing the responsibility for safe sex with the guy fucking.
If it's the other way around and they're fucking me, it might be that they don't think you're likely to catch HIV from being a top, because literature says the danger is from getting fucked without a condom, rather than pointing out that it works both ways, so they'll assume that I know they're negative and think it's fine that they fuck me.
Unprotected sex is just that and it's not like both being positive makes you immune to other infections or problems - I think that people assume that because HIV is demonised so much it's the worst case scenario, so fuck it, what is there to lose, you're already positive. The mathematics of how having the clap messes with your CD4 count aside, a dripping cock and green stains in your calvins really don't make for a good way of life.
Of course, the biggest and most important factor making me think I should not get into barebacking is, well, the shit-cock thing. I'm not sure I'd suck someone's cock straight after they've been barebacking someone - scat really isn't my scene - and getting shit on your cock is not really something likely to inspire passion in anyone.
So, for now, it's another trip to the clinic to pick up a carrier bag full of condoms, I think, and stop getting tempted by the supposedly increased intimacy of barebacking and think seriously about the clap and shitcock as good reasons to play safe as much as not wanting to transmit HIV.
Sunday, September 11, 2005
Inverted Pride
Hm. My partner's viral load is much, much lower than mine. I know what the mathematics of that implies in terms of our relative positions on graphs and such like, but I don't want to dwell on it. Instead, I'll just have to remain extra cautious because of just how infectious I am in comparison.
While I'm not going to start saying being infectious is either cool or the end of the world, what I am going to say is that I'm realising now that the worst things about being HIV positive are nothing to do with your health. Aside from the countries you'd stop someone from visiting if you infected them, you're costing the state a phenomenal amount of money in terms of health care once combination therapy begins and you're forcing someone to live with what must be the most stigmatised illness of our era. Having HIV to many people still seems like being a leper. There's an enormous pressure to disclose verbally your HIV status so people (who, "assume everyone's positive" apparently) know for sure that a mistake means risking seroconversion - what am I meant to do, turn up at a sex party ringing a bell to let everyone know that I'm the fuckup who caught this thing and I'm the fuckup who can give them this Peter Pan disease where you'll never grow old...
I'd like to see a profile somewhere on gaydar that doesn't say, "Positive in body and mind," or "HIV+ and if you've got a problem with that, it's your problem," or whatever. Why aren't there profiles that say, "I'm HIV+ and I fucking hate being positive - I really, honestly wish I did not have this condition and it's phenomenally depressing to know how dangerous I am."
I'm not happy or sorted about being infected with HIV. The thought that something has wormed its way into my bloodstream, into my brain, and is slowly shutting down my defenses against illness is a horrible, stomach-churning thought.
My partner shrugs and says there's nothing he can do about it so he's not going to worry about it, but I can't help but feel I need to grieve for this and that I need to feel entitled to the sense of anger, resentment, frustration and loss that I am experiencing without that sounding like I'm a failure.
Testing positive has had a profoundly damaging effect on my self-esteem which, like that of most gay men, is very tied to my feelings about my body and the consequences of that have spilled out into my friendships and my relationship. I don't feel I can spend considerable time with people who don't know my HIV status and feel that I am honest, I don't feel I can go out and fuck around without feeling like we should all stand in a circle holding hands and singing, "Ring, a-ring of roses..." together until we all fall down.
It's painful to think that there might be people who I have infected. I can only hope that if I have unknowingly passed it on, then those men are better-equipped than I am to cope with the emotional cancer that accompanies it all.
While I'm not going to start saying being infectious is either cool or the end of the world, what I am going to say is that I'm realising now that the worst things about being HIV positive are nothing to do with your health. Aside from the countries you'd stop someone from visiting if you infected them, you're costing the state a phenomenal amount of money in terms of health care once combination therapy begins and you're forcing someone to live with what must be the most stigmatised illness of our era. Having HIV to many people still seems like being a leper. There's an enormous pressure to disclose verbally your HIV status so people (who, "assume everyone's positive" apparently) know for sure that a mistake means risking seroconversion - what am I meant to do, turn up at a sex party ringing a bell to let everyone know that I'm the fuckup who caught this thing and I'm the fuckup who can give them this Peter Pan disease where you'll never grow old...
I'd like to see a profile somewhere on gaydar that doesn't say, "Positive in body and mind," or "HIV+ and if you've got a problem with that, it's your problem," or whatever. Why aren't there profiles that say, "I'm HIV+ and I fucking hate being positive - I really, honestly wish I did not have this condition and it's phenomenally depressing to know how dangerous I am."
I'm not happy or sorted about being infected with HIV. The thought that something has wormed its way into my bloodstream, into my brain, and is slowly shutting down my defenses against illness is a horrible, stomach-churning thought.
My partner shrugs and says there's nothing he can do about it so he's not going to worry about it, but I can't help but feel I need to grieve for this and that I need to feel entitled to the sense of anger, resentment, frustration and loss that I am experiencing without that sounding like I'm a failure.
Testing positive has had a profoundly damaging effect on my self-esteem which, like that of most gay men, is very tied to my feelings about my body and the consequences of that have spilled out into my friendships and my relationship. I don't feel I can spend considerable time with people who don't know my HIV status and feel that I am honest, I don't feel I can go out and fuck around without feeling like we should all stand in a circle holding hands and singing, "Ring, a-ring of roses..." together until we all fall down.
It's painful to think that there might be people who I have infected. I can only hope that if I have unknowingly passed it on, then those men are better-equipped than I am to cope with the emotional cancer that accompanies it all.
Friday, September 02, 2005
Perspective
Been doing a little reading this morning because the dustmen woke me up at six ("Hey! Stop with all the noise! Can't you see I'm HIV positive? Haven't suffered enough?") so I've managed to depress myself a little bit by looking through aidsnet and ticking my way through their list of countries with restrictions on travel for HIV positive people.
In typical British style, the information for visitors to the UK is contradictory. You will or you won't be tested and if you're positive you will or you won't be deported. However, given that most new cases of HIV in the UK are immigrants, allegedly (although I admit this could be racist nonsense), I'm guessing that whatever controls there are aren't that thoroughly enforced. America, though, are shitty about you trying to get in carrying HIV medication and have had a blanket ban on foreign visitors with HIV entering the country for something like twenty years. More to the point, they stamp your passport with something that declares your HIV status, not something you'd be wanting to have, unless you want bugchaser trophies.
How badly do I want to travel to countries that ban people from entering on the grounds of their HIV status, I wonder. Of course, until I start on medication, it is a simple matter to lie and tick a box on a form that perhaps I shouldn't knowingly tick. They're unlikely to fork out on expensive testing to check if anyone's lying.
Speaking of prognosis, I just found a very interesting article on aidsmap.co.uk about what CD4 count results mean. It's interesting that uninfected women have an average CD4 count 111 points higher than uninfected men and that smokers tend to have a higher CD4 count, too. Maybe it's an argument in favour of taking up the cancer sticks again.
My CD4 count at the initial test was 527. Since the normal range for people without HIV is from 400-1600, I'd assumed this was quite low, but aidsmap tells me that in a US study of people brought into an intensive care unit, the average count was 510. Compared to people with really nasty health problems requiring intensive care, I win by 17 points. I suppose that's a good thing? However, I've got to bear in mind that CD4 count fluctuates all over the shop, so what needs to be looked at is the overarching trend, which may take a year to discover if it's only every three months that it's checked.
They say that the average rate of deterioration of the CD4 count is about 40 a year and each fall of 100 points roughly doubles the chances of upgrading to first class and having "Full-blown!" AIDS. A CD4 count of below 200 is considered the danger zone, so that's when you usually get put into business class and get all the expensive drugs and can't go to America any more, but they'll start talking about it when you hit 350 or so, depending on how healthy you've been, the rate of decline and such like.
However, rate of decline is meant to follow your viral load - 10,000 is low, 100,000 is high. No wonder I scared my friend shitless when I said mine was something like 250,000 because I forgot how many digits were in it. It's 26,351, so it's on the lowish side of things. I can't seem to find the average viral load in people with HIV but it also seems subject to odd fluctuations depending on age, gender and ethnicity, so perhaps I need to look into that some more. Regardless, assuming a 40 point decline in CD4 count per year, that would give me about four and a half years before we talk about combination therapy and about eight years before I'm at 200 and will be forcefed drugs.
Thinking about it, though, the numbers and figures aren't a good guide to what could happen, what interests me really is the social and cultural prognosis, as well as the prospect of better treatments. They say sodium valproate can force the body to release dormant virus cells which can thus help eradicate them - interesting possibility, perhaps I should ask my friend's bipolar boyfriend about that, should we ever meet. They say crocodile blood could cure us and give us all peculiar regenerative powers. Interesting, huh? Sounds like we could go from blotchy zombies to superheroes pretty damn quickly, eh?
I wonder how attitudes will have changed by the time I actually could do with some intervention rather than monitoring? If they introduce ID cards, will they ask for medical information to be stored on those? With the current shift here in the UK towards the kind of police state that I'm sure should be led by a camp Sith in a cheap cloak, with fewer people gaining increasing power in the country, I do worry about the possibilities that this might imply for the socio-cultural prognosis for this country on all kinds of issues which impact on people from minority groups, so the fewer places that have a list saying I'm a gay boy with the plague the better, I say, until the revolution comes!
In typical British style, the information for visitors to the UK is contradictory. You will or you won't be tested and if you're positive you will or you won't be deported. However, given that most new cases of HIV in the UK are immigrants, allegedly (although I admit this could be racist nonsense), I'm guessing that whatever controls there are aren't that thoroughly enforced. America, though, are shitty about you trying to get in carrying HIV medication and have had a blanket ban on foreign visitors with HIV entering the country for something like twenty years. More to the point, they stamp your passport with something that declares your HIV status, not something you'd be wanting to have, unless you want bugchaser trophies.
How badly do I want to travel to countries that ban people from entering on the grounds of their HIV status, I wonder. Of course, until I start on medication, it is a simple matter to lie and tick a box on a form that perhaps I shouldn't knowingly tick. They're unlikely to fork out on expensive testing to check if anyone's lying.
Speaking of prognosis, I just found a very interesting article on aidsmap.co.uk about what CD4 count results mean. It's interesting that uninfected women have an average CD4 count 111 points higher than uninfected men and that smokers tend to have a higher CD4 count, too. Maybe it's an argument in favour of taking up the cancer sticks again.
My CD4 count at the initial test was 527. Since the normal range for people without HIV is from 400-1600, I'd assumed this was quite low, but aidsmap tells me that in a US study of people brought into an intensive care unit, the average count was 510. Compared to people with really nasty health problems requiring intensive care, I win by 17 points. I suppose that's a good thing? However, I've got to bear in mind that CD4 count fluctuates all over the shop, so what needs to be looked at is the overarching trend, which may take a year to discover if it's only every three months that it's checked.
They say that the average rate of deterioration of the CD4 count is about 40 a year and each fall of 100 points roughly doubles the chances of upgrading to first class and having "Full-blown!" AIDS. A CD4 count of below 200 is considered the danger zone, so that's when you usually get put into business class and get all the expensive drugs and can't go to America any more, but they'll start talking about it when you hit 350 or so, depending on how healthy you've been, the rate of decline and such like.
However, rate of decline is meant to follow your viral load - 10,000 is low, 100,000 is high. No wonder I scared my friend shitless when I said mine was something like 250,000 because I forgot how many digits were in it. It's 26,351, so it's on the lowish side of things. I can't seem to find the average viral load in people with HIV but it also seems subject to odd fluctuations depending on age, gender and ethnicity, so perhaps I need to look into that some more. Regardless, assuming a 40 point decline in CD4 count per year, that would give me about four and a half years before we talk about combination therapy and about eight years before I'm at 200 and will be forcefed drugs.
Thinking about it, though, the numbers and figures aren't a good guide to what could happen, what interests me really is the social and cultural prognosis, as well as the prospect of better treatments. They say sodium valproate can force the body to release dormant virus cells which can thus help eradicate them - interesting possibility, perhaps I should ask my friend's bipolar boyfriend about that, should we ever meet. They say crocodile blood could cure us and give us all peculiar regenerative powers. Interesting, huh? Sounds like we could go from blotchy zombies to superheroes pretty damn quickly, eh?
I wonder how attitudes will have changed by the time I actually could do with some intervention rather than monitoring? If they introduce ID cards, will they ask for medical information to be stored on those? With the current shift here in the UK towards the kind of police state that I'm sure should be led by a camp Sith in a cheap cloak, with fewer people gaining increasing power in the country, I do worry about the possibilities that this might imply for the socio-cultural prognosis for this country on all kinds of issues which impact on people from minority groups, so the fewer places that have a list saying I'm a gay boy with the plague the better, I say, until the revolution comes!
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