Round Two

Well, seemingly I spoke too soon about sex with other positive guys being less complicated and wound up in the clinic getting antibiotic jabs. I guess that's just another indication that nothing's changed. I also picked up my new viral load count, but they lost my CD4 count. I did jokingly ask the doctor if that meant I had a CD4 count of zero, but they took the blood again. It seems I've spent the main part of the last few months with tracklines on my arms from one blood test or another. My viral load is now 41,000 or something, which rather throws my hopes that I was such a recent infection that my viral load was going to get lower.

I didn't really want to think about it at the time, but it could be an anomalous result because, as the doctor said, I had a concurrent infection. It's slightly daunting to think that every time I get ill, it will be with a concurrent infection. Just another reminder that I carry a spreadable disease.

I guess that's the rub with HIV. There's all the drama and the novelty of the initial infection, then there's just this gnawing constant because it will never go away. Any infection from now until the day I die remains a concurrent infection. That's a deeply unpleasant thought, although one to keep in perspective. Having a lower viral load isn't some kind of contest, there's no moral weight attached to being less infectious. It's not like there's some correlation between your numbers and the circle of hell to which you will descend.

I know, intellectually, that it's a minor fluctuation in the scores, and likely one to do with the concurrent infection I had at the time, but I can't help but shake the feeling that, oh, God, it's double what it was. I'm twice as infectious as I was when I was diagnosed.

I suppose it would pay to keep that in mind when I start to get complacent or whenever anyone thinks to convince me of the merits of barebacking.

The Blue File

Well, I've been back to the clinic, had some more blood taken. I had a virus (another virus) at the time so I wonder if that will have dented my CD4 count when I pick the results up in a couple of weeks. Sitting in the clinic waiting room, I found myself thinking about my HIV status for the first time in a couple of weeks. To be honest, it doesn't play on my mind nearly as much now that the initial novelty or horror of it has worn off and there's still bills to pay, still work to do, still people to see.

After sitting there for a few minutes, I noticed that my file was a thick, blue, ring-bound file, whereas most of the other people there had thin, brown paper files. Clearly, the thick files are for HIV+ patients and I did kind of have a little bit of a sad, yearning moment there for the time when my file was a thin, brown paper file. It's probably not really brilliant in terms of disclosure that there is this differentiation, because after my initial sadness at being the only blue file case while I was waiting, a few other guys came in and after fifteen minutes of watching people going in to see doctors, nurses and health advisors, I knew the HIV status of all the people waiting there that day.

I talked to the doctor, who was very friendly and reassuring, mainly just to check in with them to know that I'm okay, which I am on the whole. It's still a learning curve, and I'm realising now that it's not some scythe hanging over me, it's not some black mark on my forehead, seared in my skin. The stuff in the papers about how HAART resistance is increasing and how HIV resides in the brain is hard to take, partly because of the way the papers talk about HIV infected people as some kind of "Other" which has a strange impact on how I feel I fit into society if I am suddenly some invisibly different and dangerous chameleon.

I also talked to the doctor about my moles, she's going to write me a referral letter to the dermatologist at the hospital to talk about options. I'm currently of the thinking that I'd like rid of every last one of them, but I don't think they would recognise that as a clinical need.

I've stopped thinking that every time someone doesn't text me back, say they're up for a shag when we used to shag or they don't reply on gaydar that it's because I'm positive and they hate me for it. Of course, that's only the people who I know now know, though, and that's not a pool of people I would like to see increased. The people who know, on the whole, it is on a need to know basis, that they're either likely to come into contact with me sexually, my blood, or that they are the people I turned to in what I thought was my darkest hour of recent months. I'm okay with those people knowing, and I really do appreciate the support and love I've been given during that time, but, for instance, one guy who knows doesn't seem to talk to me so much, I wonder if that's just that we've drifted apart and another guy I am less keen on spending time with than I was when I told him. I'm not so anxious that I think I need to keep him on-side in case he goes out and tells everyone. "So what?" would be the key response, I think.

Run Down

I've thought much less about being positive this week, which I think is a healthy sign. Had sex with one guy this week who was positive which was so different to the experience the week before, not just in terms of different men having different bodies and different personalities, but in terms of the anxiety just not being present. Perhaps I should still be anxious about re-infection, but the evidence doesn't seem to be there for any indication that having different strains of HIV makes any difference to your prognosis. Nevertheless, until this year, they didn't think fucking someone without a condom was high risk and look at where I am now as a result of that ignorance.

In any case, I don't think that by any measure the psychological impact of reinfection would be anything like infection in the first place. I know that it's starting to sound like serosorting, but I'm not going to analyse it to that point if I can avoid it. It's just as likely that I was more relaxed this week because I'd processed all the guilt and shame that went with the guy's concerns the week before. I'm pretty sure it's largely that, because the guy who I said had freaked out has been sending me friendly texts and stuff and not mentioning it again, so it probably was more of an issue for me rather than him.

You know how they say in safe sex stuff about how people tend to assume people have the same HIV status as themselves? I'm kind of worried I'm starting to do that. Whenever a friend says they have a cold or anything, I assume it's because they're positive. This is something I'd really like to nip in the bud, and it's probably another projection of my own anxieties about my status onto other people.

Bleeding Moles

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.

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.