It's practically passé to get your blood drawn in a doctor's office these days, especially when you can do a mouth swab or finger prick test at venues like these.
The moments after learning you’re HIV-positive can seem like a virtual free-fall. In a matter of seconds, you are sent into a tailspin of what-if scenarios and your vision is filled with horrific images from a bad movie montage. Your mind races, then stalls completely, working in frantic fits and spurts and grasping onto the few nuggets of information you can remember about what it means to be HIV-positive today.
The nurse tells you that you are going to be just fine and that HIV is now a manageable disease. The doctor tells you that if you take care of yourself, you can expect to live the same length of time as you would have if you didn’t have HIV.
Even with the reassurance, there's an inescapable fear of the unknown. What does it mean to live with HIV? What's going to have to change in your life, and more importantly, what can you expect to remain the same?
You aren’t alone. There are so many others who have gone through the exact same thing and have already asked all the same burning questions that you now need answers to. Below are some quick answers to those top questions.
What do I do now?
The first thing to do is to stop panicking. You are the same person who walked into the clinic before receiving your test results. It may seem like everything has changed, but it hasn’t. Still, there are some things you can do to ease your mind and find your way back to being OK.
Do I need a different doctor?
You do need to find a doctor who is highly knowledgeable about HIV and one who is the right fit for you. You might be surprised about how unknowledgeable your average family doctor is about HIV and how best to treat it. The last thing you need is to be treated by a doctor who has just as many questions as you have. There are many HIV specialists, usually they are called infectious disease specialists, who know exactly how to treat you, how to ease your concerns, and which of the hundreds of different treatment combinations are best for you. These doctors can also act as your primary care physician, and keep your HIV treatment in mind when minor health issues arise along the way.
What happens at my first doctor’s appointment?
During your first appointment, your doctor will draw blood to do your initial lab work. This is to see what your CD4 count and viral load are. Your CD4 count is the number of disease-fighting white blood cells you have in your body and your viral load is the number of copies of HIV that are in your blood. So you want your CD4 to be high and your viral load to be low (and eventually, hopefully, undetectable).
This sounds scary, but it doesn’t have to be. No matter what your CD4 count may be, many newly-diagnosed people can bring their count up by simply taking a single-pill regimen. The same medication can also reduce your viral load to an undetectable level, making it highly improbable for you to transmit the virus to someone else. Your doctor will also determine whether the virus strain you have is resistant to any specific medications, which happens but is unlikely.
Most likely, this will be the extent of managing your virus, along with regular checkups with your doctor to make sure that your body is healthy and that your medication is working. The key to staying healthy and keeping an undetectable viral load is to never miss a dose — just as you should with medication you’re prescribed for other ailment.
Can I only have sex with other people who are also HIV-positive?
Of course not! Today, there are multiple ways to have safer sex, and believe it or not, most men are knowledgeable enough to know that informed sex is the safest sex of all, regardless of HIV status. Condoms, PreP (for you partner), and treatment as prevention can all help keep everyone safe. Again, staying compliant with your meds and maintaining an undetectable viral load is the best way to ensure that you never transmit the virus to a sexual partner. This method of prevention is for your protection just as much as it is for your partner — and the bonus is, it helps you stay healthy.
How will I tell my friends and family?
First off, you don’t have to tell anyone except your recent past and future sexual partners. But talking about your status may be the best way for you to feel like yourself again. There are probably other people around you who are either HIV-positive or have been affected by HIV in one way or another. The first time you tell someone may be scary, but it gets easier every time. The first step is to just say the three little letters out loud. Start there.
What does it mean to manage my virus?
For most people who are diagnosed today, managing your virus simply means being compliant with a one-pill-a-day regimen. Once you find a doctor, start medication, and achieve an undetectable viral load, you will just need to have your lab work done every four months or so to make sure that everything is all right.
Am I going to die?
Here’s the deal. A person diagnosed today has roughly the same life expectancy as a person who is HIV-negative. However, your virus does make you more susceptible to several other health problems that you need to be aware of. Some of these are cardiovascular disease, kidney problems, and bone density loss. But before you start to panic again, know that these can be prevented with the proper care. Being knowledgeable about what to look out for is the best way to ensure a long and healthy life.
Am I going to get AIDS?
The term AIDS does seem scarier than HIV, doesn’t it? The truth is, many people who are living with HIV will never be diagnosed with AIDS. HIV is a virus; AIDS is a diagnosis that a person receives once the virus reaches a certain point (many healthcare workers now call it HIV 3, because that’s the stage of the virus). When your CD4 count dips below 200 and your immune system is so damaged that common illnesses can be life-threatening, your disease is classified as AIDS. For many who are just diagnosed, if you stay on your medication and keep a healthy body and mind, you can keep your CD4 count in the healthy zone and far away from the level of AIDS. And if your CD4 count is already in the danger zone, the correct medication can bring you back up to healthy levels.
Just remember: Even if the test is positive, your diagnosis is not the end of anything. It may be the beginning of living a more informed and health
One out of every two black gay and bisexual men will be diagnosed with HIV within their lifetimes. That’s what the Centers for Disease Control and Prevention now predicts: 50 percent of all black gay and bi men will become HIV-positive.
Although it has become a manageable chronic condition for many white Americans, HIV is still a deadly disease among African-Americans. Despite being only 14 percent of the U.S. population, blacks represent 54 percent of the deaths attributable to HIV and AIDS-related conditions. Late or non-existent testing and/or treatment are both to blame. But there’s more.
Among African-Americans there are currently 20.5 deaths for every 1,000 people living with HIV. As of 2012, there were nearly a half a million African-Americans living with the virus. Without changes, that will translate to over 10,00 deaths. That’s a small town. Stacked end to end, 10,000 coffins would rise to more than three times the height of the Empire State Building.
All because stigma and shame keep us from addressing HIV and the hole it is tearing in the fabric of our community. How does this happen? Sure, we can point to social reasons African-Americans are bearing the brunt of HIV, including poverty, racism, mass incarceration, and poor medical care, but individuals, each of us, is playing a role too. When we make HIV a taboo subject, when we treat LGBT people and those with HIV like pariahs, we help make it so one in eight HIV-positive people doesn’t know their status.
Not knowing your status means you don’t get into care and don’t stop transmitting HIV to others. Stigma keeps those who do know their status from seeking help, which is one reason why only 37 percent of African-Americans who know their status are receiving antiretroviral medications. Of those in care, only 29 percent have achieved viral suppression; the point where the virus is contained and their chances of transmitting HIV drops dramatically.
These statistics may be disheartening, but they don’t have to determine our destinies. We can alter our futures by taking control of our health and valuing our own lives. Acting like black lives matter—like our lives matter—means getting tested for HIV. Acting like black lives matter means getting in care if we’re positive or considering preventative options like PrEP if we aren’t. Get tested. Get treated.
Just act like Black Lives Matter — because they do.
In a world where people still use the word “clean” to refer to those who aren’t living with HIV, it’s clear that there’s still a lot of stigma about being (or dating) someone with HIV. But we have more tools than ever to make sure those who are negative continue to be so no matter who they happen to date. Today’s antiretroviral medications can suppress the viral load of those who are positive, making them highly unlikely to transmit HIV even without the use of a condom. Meanwhile, PrEP — the pre-exposure prophylaxis also known as the HIV prevention pill — has been shown to be up to 99 percent effective in preventing HIV transmission between serodiscordant couples. Sex across between positive and negative partners has never been safer. After years of condom-only safer sex messages, we finally have options to explore our sexualities and still play safe. But, in this brave new world of sexual opportunity you have to know your status in order to know what safety gear (or meds) you need to play the field.
Knowing whether or not you have HIV is the sexiest choice of all when it comes to dating and here’s why.
Honesty is the best method of safe sex. Once you get your HIV test, regardless of status, it’s time to play safe. Out of all of the tools in your safe-sex toolbox, honesty is the most effective when it comes to preventing HIV. Whether it is being honest with yourself or with your sexual partners, telling the truth about your HIV status, or when your last HIV test was, honesty can have up to a 100 percent efficacy ratio when used correctly. It doesn’t matter whether you are a top or a bottom, HIV-positive or HIV-negative, using honesty will allow you to combine other methods of prevention to ensure your safety without taking away from your ability to have a good time in the sack. But here’s the catch: you can’t be truly honest if you avoid knowing the truth. It’s only by knowing your status that you can really be honest about HIV.
Knowing your status means you’re brave. All that stigma around HIV makes getting tested for HIV a scary prospect; you may face rejection from your family, your friends, your sexual partners and even your church. There are plenty of people who deal with that fear by denial. Some folks even think it’s better not to know. But without knowing, you can’t really live your best life. We all have to make a choice. You can either anguish over the potential rejection and gossip you’ll be subjected to or you can thrive off of those who only want happiness for you. No matter who you are or what your status may be, make sure your own hand isn’t holding the knife wedged in your back. Facing the unknown is always scary, but there’s nothing sexy about someone who lets fear limit their life.
Getting tested shows you believe in those who support you. Sure, you might feel lonely sometimes, but knowing your status is proof you are part of a social world, a world where you have and will interact with other people on an intimate level. Getting tested amidst all this HIV stigma also means you have people you believe will support you — otherwise you’d still be hiding in your room. You know the people who really love you would want you to get diagnosed and start treatment for something that could be a manageable chronic condition; rather than waiting until it has become a life-threatening illness. Being the kind of person who has a supportive social network is way sexier than being the kind of person who is surrounded by people who’d reject them for having health issues.
Knowing your status means you have confidence. Confidence is sexy. When you’re confident you actually hold your body a different way, standing taller, holding your head high. You meet people’s eyes, you are willing to let people see the real you because you’ve accepted who you are. There’s something magnetic about confident people. If it is love or a relationship you seek, someone will believe that you are worth taking to breakfast the next morning only if you do. There are countless reasons why someone will reject you, but the right person will only stick around if you believe you are worth it. Getting tested for HIV is a sign that you know you can deal with whatever life throws at you. Whatever the outcome is, that confidence is sexy.
Because treatment is the new sexy. If your test is positive, you can act quickly, get treated (with what, for many, is generally only 1 pill a day), and often get to an even healthier body than you had before because you're in care. Even better, you're utilizing Treatment as Prevention (or TasP), which is when someone who is HIV-positive achieves an undetectable viral load through the use of consistent antiretroviral medication, to change your dating and sex life forever. When a person with HIV has a viral load that is suppressed to undetectable levels, they reduce their risk of transmitting the disease by 96 percent (which makes it statistically safer than our old standby, condoms!). To date, there has not been one confirmed case of someone with a suppressed viral load who has transmitted HIV. Study after study, TasP has been proven to work. When evaluated with the added benefits associated with antiretroviral meds, it’s simply the best HIV prevention methods out there. Imagine a dating life in which you know you can neither acquire HIV nor pass it to others? That’s sexy.
It means you take responsibility for your own health. As much as we’d like to see HIV testing become part of routine medical screening; at the moment, people generally don’t get tested unless they think they may have come in contact with HIV. While others are in denial about how their activities or partners may have put them at risk, you’ve acknowledged that risky behavior, safer sex slip-up, broken condom, drug use, or choice of partner may have exposed you to the virus. Getting tested enables you to learn your status, which is the first step in maintaining your physical, mental, and sexual health. You know your health may be impacted by what others do, but you’re the one who has to make the healthy decisions about your own body.
Knowing your status means cracking that closet door, sometimes twice. Studies have proven that being in the closet isn’t good for your mental or physical health. Coming out is always healthy. The first person you come out to is yourself; whether you’re acknowledging you might be bisexual, recognizing you’re an atheist, or getting tested to learn your HIV status, it all starts with you. The fact that you’ve taken that first step is sexy. Coming out as HIV-positive may seem like about as good of an idea as a face tattoo, and fear of rejection will gnaw away at your self-confidence while you toy around in your newfound closet until you start talking. The more you talk, the easier it gets. Sharing difficult information about ourselves is a critical element in developing intimacy — whether it be with friends or lovers. Your willingness to open up can become one of the sexiest things about you.
For those with access to healthcare, not knowing your status is kind of a dick move. Here’s the deal: We know between 13 percent of people with HIV don’t know they have it. They are the people from whom most others are getting HIV. Many of those folks lack of access to healthcare or transportation or are so deeply disenfranchised that they haven’t been able to get tested. But for a lot of us, not getting tested happens because we think we’ve never had unsafe sex or sex with an HIV-positive person, or we’re afraid, we’d rather not know, or we don’t think it matters. Even if you don’t care enough about yourself to know, just think of the next guy or gal you’re having sex with. Wouldn’t it be a lot sexier if you knew your status and how to best protect your health and theirs?
Knowing your status opens up your sex life. Orgasms are wonder drugs; your doctor wants you to keep having them. Other people are still attracted to you, but now you can assure them you know your status and how best deal with it. And there are plenty of attractive HIV-positive people out in the world today including models, athletes, musicians, and even a slightly crazy leading man TV star. You’ll still be attractive and desirable regardless of what that test says. You may actually feel sexier and more confident knowing the answer; and that will make you sexier to others too.
Among African-Americans there are currently 20.5 deaths for every 1,000 people living with HIV. As of 2012, there were nearly a half a million African-Americans living with the virus. Without changes, that will translate to over 10,00 deaths. That’s a small town. Stacked end to end, 10,000 coffins would rise to more than three times the height of the Empire State Building.
These statistics may be disheartening, but they don’t have to determine our destinies. We can alter our futures by taking control of our health and valuing our own lives. Acting like black lives matter—like our lives matter—means getting tested for HIV. Acting like black lives matter means getting in care if we’re positive or considering preventative options like PrEP if we aren’t. Get tested. Get treated.