Thrown.

Dear Going Gentle,

Hope things are going well with you.

Your blood results from 7/2/08 were fine. They show that starting HIV treatment can be delayed for the time being as your count is above 350.

The CD4 count was 433 and the viral load was 17273 indicating low viral activity.

I would advise you to keep your appointment with Dr McAids next week to discuss these latest results and where to go from here.

Regards,

Dr Death

Your Friendly Local Clinic for HIV and Sexual Health

Names changed to cast a vague haze of anonymity over the whole thing. It's an odd spanner in the works. I'd been expecting the result to be like my last 2, hovering around the mark where I'd need to talk about starting treatment. Now, I'm not so sure. It's a tricky one - do I keep playing this lucky numbers game or do I think about how my health has been as more of a barometer? I've been ill quite a lot this last six months with various niggling and not so niggling infections and now I just don't know. Well, I'm still seeing the doctor on Monday, I guess we'll have a serious talk then. I guess I'd kind of been so prepared for my system to be in freefall, having a healthier result's a bit of a surprise.

Medication, woah medication!

It's starting to look like medication is, in fact, what I need. Hmm, maybe the comparison to Roy Castle isn't so good - look where his dedication got him.

I went to the clinic last night to get my bloods done, same as always, and I had a chat to the guy there about it - I've been iller this last six months than I think I can ever remember being. I'm a one-man MRSA factory, too, because I've had about five or six courses of antibiotics in as many months. He seemed to think I was right to bring it up - my last couple of results are in the range where it's worth starting to think about it, but if I'm feeling unwell, then it's a good time to make a start on medication.

Pretty much everyone I've talked to about it has found very few ill effects with their medication - especially people who've started recently, so I'm not worried so much about that; I'd just like to be able to feel well most of the time rather than some of the time and I'd like to know I was that little bit less infectious.

I'm going back in about 10 days to talk to a doctor about which combination is likely to suit me best. Until then I'm going to try not to think about it too much.

Healthy Living

I think the low CD4 counts of the last year are starting to be reflected in my overall health. I'm just finished on yet another course of antibiotics for an infection. After all the chest infections, throat infections, upper respiratory tract infections, sinus infections and the like I've had this last year, I've just had an ear infection that took me completely by surprise and managed to burst my eardrum.

Antibiotics have helped and it doesn't hurt nearly as much as it did. I'm waiting for my hearing to come back, which is happening all too slowly so far, but in the meantime it's kind of floored me, making me think that this might, in fact, be a reflection of my deteriorating health.

I've got more blood tests in a couple of weeks, along with audiology and the rest. I guess it has to happen at some point that I start on medication; I'm starting to wonder if I'd rather get it done now before any other lasting damage is done... it's a bit annoying.

New Year, Same Old AIDS.

It's the time of year when everyone's talking about their amazing plans to radically change their lives - I thought I'd have a nosey through some other HIV-related blogs on the internet and came across this curious article about people who, through willpower alone, "beat" HIV. It struck me as a little bit sad. Not that I'm denying that remaining upbeat and trying not to allow HIV to make you its bitch can't help with your prognosis, it's just the sense that it's clutching at straws to say things like, "Well done!" to a guy in Berlin who stopped medicating for HIV and has seemingly remained healthy with a barely-detectable viral load. The patient seems to attribute his luck to his will, the doctors are less optimistic, saying that it looks more likely to be something to do with early intervention and experimental drugs if his spontaneous recovery proves to last at all.

The science of it is beyond me, but what interested me about it was the way that it was presented, offering a glimmer of hope to some people who are often quite desperate. I guess I'm pretty well-adjusted about the whole HIV thing - I can get on with life now without thinking about it all the time, I don't seem to be going through the depression or substance abuse that seems to be rife among other people with the virus and I'm pretty sanguine about the whole thing.

It sounds like what gets a lot of people with the virus is a very understandable fear. For my part, if a few people have had the good fortune to have tested HIV positive and now test negative - good luck to them, I say, but I've got plenty to be getting on with without spending half my time on my knees praying for a one in a million shot at divine intervention.

Inexorable

A few guys I've spoken to have said that the thought of infection turns them on. Specifically not just the thought of flesh-to-flesh contact without the barrier of a condom, but the prospect of contracting HIV. While I think there's a bit of urban mythology about bugchasing, I think there's some slight truth in it for some people I've spoken to. What they talk about is an end to the fear and uncertainty of being "negative at my last test" and the ongoing dread that accompanies each of those tests. There's also the way that HIV positive people have had to go through a challenging period of self-evaluation and some of us come out of that chewing our own faces off in clubs, getting fucked by strangers, while others have used that crisis as a springboard into a position where we value our health and our lives a lot more than we used to.

Neither's any more appropriate a response than the other to the acquisition of a potentially life-threatening disease, but to willingly choose a slow, inexorable suicide seems like an interesting choice. Personally, I've not attempted suicide or been anywhere near it since my diagnosis, but had been previously. On one level or another I think I acknowledged that the matter taken out of my hands now so there was no merit in trying to hurry it along. Far from being nihilistic, knowing that death swam with me gave me a lot more to find good about life.

I wonder if that low-level creeping nihilism that underpins the ennui that many people feel these days drives some of us to situations where the matter could be taken out of our hands and we'd seek out, consciously or otherwise, an end to the fear and uncertainty that comes with being negative to replace it with the inexorable certainty of being HIV positive.

I don't for a moment think that the majority of people feel this way, but I have had conversations with more than a few guys who have said that they fantasise about it and secretly wish for situations where it could happen.

I don't plan on granting anyone's wish this Christmas.