In a previous post, I’ve mentioned HIV and the division it has caused between gay men who are positive and negative, and I would like to elaborate on this point from a personal perspective. I am going to share my own feelings as an HIV-negative man and how the disproportionate prevalence of HIV in the gay community has affected my mental health.
Since coming out at 17 I’ve always had a slight paranoia of HIV. Growing up I was very influenced by the media and the idea that HIV was a “gay disease” was imprinted deeply in my head. Being romantically involved with someone who was positive was out of the question because infection would be inevitable. As I’ve grown older and explored my sexuality, the fear of HIV infection has also grown and I often have unhealthy perceptions of risk. For instance, it may only take one slip up of unprotected sex for me to obsess on the idea that I’ve become infected. There were times when after an encounter I would spend hours reading about symptoms of HIV infection online and I would self-diagnose if any of them seemed to be happening. If I got a cold or sore throat that lasted longer than a week I convinced myself it was because of sero-conversion affecting my immune system. I would stay in this mindset until I eventually told myself to get tested. In Calgary the testing requires a week for results, so I would spend this time mentally preparing myself for the news and figuring out how my life would change if I was positive. Then I would go into the clinic, wait in utter distress for my name to be called, and then finally be told the inevitable. “Mark you are negative.” Waves of relief overwhelmed me and I felt foolish for being so concerned. Of course I’m negative. What was I so worried about? It was only one encounter where I wasn’t safe.
The statistics on HIV infection rates have always confused me. Unprotected anal intercourse is considered the highest risk for infection, but for the insertive partner the risk is still under 1% per exposure*. These estimates vary based on a persons viral load and how long it’s been since they were infected, but looking at these odds do make my fears seem excessive. Even still, it’s better safe than sorry and should be followed up with testing. I just find it frustrating how the shame and stigma associated with ‘bare-backing’ (or sex without a condom) has made me feel that no matter the risks, or how much I discuss status with my partners, or protect myself despite the occasional slip up, that HIV infection is a looming possibility in my life as a consequence of my actions.
In 2012 I experienced another instance of HIV-paranoia, however this time my fear was more justified. I need to start off by mentioning that when I initially moved to Toronto I was enthralled with the larger gay community. It didn’t take long before I started going to ‘Steamworks’ which is a gay men’s bath house where anonymous sex is common. I don’t condemn bathhouses; I think they serve a purpose as a sexual outlet for people, however anyone who visits them needs to make smart decisions, have a clear understanding of risk, and not let themselves get carried away. I was usually good at this and would mainly spend my time in the hot tub or sauna and just watch other people engage in sex, with only the odd occurrence of low risk behaviors.
However on Halloween that year, alcohol was involved, and I ended up letting myself get carried away. I met someone in the hot tub and we immediately started making out and ended up back in his room. The entire experience was a bit blurry but at some point there may have been penetration, I can’t really remember to be honest.
It was a very quick encounter and I left shortly afterwards but made sure to get his phone number. That night I felt weird about the whole experience and didn’t sleep very well. It was mainly because of the idea that I may have had unprotected sex with someone in a bathhouse. It seemed wrong, dirty and dangerous. As soon as I woke up the next day I sent him a text asking if he was positive or negative and he told me positive. I immediately freaked out.
What was I thinking? Why didn’t I use a condom? Why didn’t I ask him this last night? Did we even have sex?
I couldn’t remember. He told me we didn’t but I still wasn’t sure. I wasn’t mad at him, just fearful for myself. I called the hassle free clinic right away for options and was advised of PEP (Post-exposure-prophylaxis). They said I would need to go to Saint Michael’s hospital downtown to get an initial dose and then would be given a prescription for the rest. It’s around $1,500 for PEP but I had employer health benefits and was covered. I did happen to have a friend visiting me at the time from Calgary and he was a great support. We drove to the hospital, and I was admitted right away to see a nurse. I explained the circumstances and she again reassured me with statistics that the odds were in my favor but just as a precaution, it would not be a bad idea. PEP needs to be started within 72 hours of possible exposure to be effective so I took the first treatment right there. There are two medications involved taken several times daily and adherence is mandatory to guarantee maximum efficacy. Afterwards we went to the pharmacy for the rest of the prescription. The entire process is a month in duration with follow-up testing at various increments of time of up to six months. Also, the lab needs to assess your blood to make sure the medication is not being harmful on your body. PEP is actual HIV medication and you are following the regime of an HIV-positive person while doing it. It was a very stressful time and I berated myself a great deal for not being more careful.
My initial test result was negative and my feelings were very mixed the whole time I was on the treatment. I was proud I was being pro-active and doing something to protect my health, angry that I had let myself get into this situation in the first place, annoyed because I was probably over reacting and didn’t even need the treatment, isolated because I didn’t want to tell anyone what I was doing and finally disheartened because this scenario is far too common in the lives of gay men. My final test result was negative.
I learned a great deal from the whole experience and am now even more careful when I meet someone. I still think a lot about HIV and if my life would change significantly if I was positive, but deep down I know this is not the case. Friends of mine who have been diagnosed live happy, healthy lives and are involved in outreach work to fight against the stigma, shame and feelings of paranoia that I have just discussed. It is now possible for negative and positive men to form meaningful relationships and not have the risk of infection which existed previously. In addition to PEP, there are new emerging medications such as PrEP (Pre-Exposure-prophylaxis) which when taken correctly by an HIV negative person, reduces chances of infection significantly; and when used with condoms the risk becomes almost non-existent.
I hope that one day there will be both a vaccine and a cure but ample progress has already been made. HIV is such an unfortunate part of the gay movement because gay rights were on the rise after the stonewall riots in the sixties, but the emergence of HIV/AIDS in the eighties took us a step backwards (This is my own opinion, some people feel it brought attention to gays and pushed the movement forward).
Today I remain healthy and by regularly going to the gym and being on Celexa has helped me to feel better both physically and mentally. I am glad I had the opportunity to share this story with everyone and hope that it will both educate people about the importance of HIV testing, and also inform people that there are more options out there to remain negative, and that even if you are positive, it is not a death sentence and it is possible to live a happy, normal life. Only by reducing stigma, being safe and coming together as a community can transmission really be reduced and allow for the possibility of an HIV-free future.
About Mark Rob
Mark Fraser is a 30 year old man who has lived with depression, anxiety and obsessive thought for much of his adult life. Since coming out as gay in high school he's had difficulty relating to others in his community and has experienced self-doubt and a pensive outlook for his future. Mark moved to Toronto in 2012 and has become involved in Second City Improvisation classes as well as personal training in order to maintain his physical and mental health. He has expressed interest in blogging with Healthy Minds as a means of reaching out to others who feel isolated and as a way to express himself in a positive space. You can connect with Mark on Twitter or Facebook.