Dr. Jillian T. Weiss

Comment of the Week: Capitalist Piggy on HIV-Neg

Filed By Dr. Jillian T. Weiss | May 29, 2011 6:00 PM | comments

Filed in: Living, Site News
Tags: HIV/AIDS, negative, seronegative, seropositive, vaccine

Comment of the WeekOn Mark S. King's Calling HIV-Negative Men: This is Your Time, praising HIV-negative men for the bravery required to take an HIV test every few months, given the psychological trauma to be endured waiting for results, and noting their importance to ongoing vaccine trials.

Some Projectors said it's a mistake to call this bravery, which should perhaps be defined as running into a burning building with no chance of escape. Rather, taking a simple blood test regularly is just the responsible thing to do, like brushing your teeth. Projector CapitalistPiggy, however, noted that it's not as simple as waiting for a blood test result. He also made the point that a lot of stars have to line up to maintain HIV-negative status, including one's own courage to admit a mistake and to take immediate action.

Mark-

Thanks for this article. I am having a first-hand experience in PeP as we speak. I did something rather stupid. Luckily, I have good friends around me who all insisted that I see my Doctor first thing on Monday morning. I'm glad I did.

I have a gay doctor. I came in with the face of shame, and he immediately reassured me, and said, we all make mistakes, I have before, and you're going to do what I did, and go through PeP treatment.

Before I know it, I'm at the pharmacy. The Doctor had written PeP on my prescriptions. The pharmacy said it would take two hours to fill- I did like my Doctor said and showed them the word PeP on it and all the sudden they told me it would be ready in 15 minutes.

I took my first dose of Truvada and Isentress before 24 hours of exposure had passed.

Baseline bloodwork has already come back - everything looks good. Taking these drugs has given me a new respect for people who must take them everyday for the rest of their life, of which I hope to NOT become one.

The first week was nasty, my stomach was bloated and all upset and my body generally just felt ran-down. After a week, those side effects have mostly subsided, of which I am very thankful. I've been on treatment for two weeks and am proud to say I have not missed a dose.

I feel extremely lucky. Lucky that I had good friends who insisted that I go to the Doctor. That I have a Doctor who is gay, knew what PeP was, did not judge me, but empathized, and put me on a course of treatment immediately. That I had a Doctor who knew the Pharmacy well enough to get me bumped to the front of the line, all by putting PeP on the script.

I wonder what would have happened if I had of gone to a doctor in a rural area. Would they have known the appropriate course of treatment? Would they have given it to me?

I have two more weeks of these drugs to take. Then get tested in the following month. I am very hopeful that things will work out for the better- that I will remain HIV-negative. The experience has taught me that I need to value myself more, and not allow myself to be put into dangerous situations, out of depression and self-hate. It has taught me that I love myself enough to protect myself, no matter what the other guy says.

It has also taught me that these HIV-drugs are no panacea. They side effects suck and they definitely change your quality of life. I have so much more respect for people that are HIV-positive. I've sometimes thought, what is the big deal if I become positive, I'll just pop a couple of pills a day. Well, it is a big fucking deal.

I feel blessed that I live in a time where PeP is known about and available. Every gay man living has made a mistake when it comes to sex. I'm just glad there is an option now to hopefully make those inevitable mistakes that will happen, a thing that you can learn from, and not something that will plague you for the rest of your life.

In all my relations.

What say you, Projectors? Are HIV-negative men worthy of praise as brave, or not? Does it take courage to maintain an HIV-negative status, or not?


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hi, it's the first time i post here and i have a question! i did not understand what PeP is? i'm not in the US so i do not understand what that word means, so can anyone explain to me what PeP is? i quite understood was a a medicine or something.

thank you

Hanako

PeP, as used here, refers to Post-Exposure Prophylaxis, the practice of taking anti-HIV meds as quickly as possible after a known or suspected exposure to HIV. Do not confuse it with PreP, which is Pre-exposure Prophylaxis.

[=Here is a link=] to an excellent explanation of PeP on the website for Project Inform of San Francisco, a fine community group that helps HIV-affected people understand and keep up with the complexities of medical knowledge surrounding the HIV/AIDS epidemic.

Eric Payne | May 30, 2011 3:21 AM

I'm going to be brutal in my language (and possibly, my opinion), but PeP is a, hopefully, preventative measure because someone got drunk and decided to get fucked without a rubber, or they got caught up in the white-hot passion of the moment and decided that any pause would kill the moment so skipped the rubber, or did a momentary risk analysis and decided, somehow, their fuck buddy of that night couldn't possibly be infected, or... well, any number of reasons.

All of them stupid. Some use the cop-out "the condom broke!" Here's a clue guys... if the condom breaks... stop fucking and put on a new one.

So, basically, the day after (or sometime after, it's all dependent on the person) guilt and fear start setting in, and the person goes to their doctor, admitting they recently participated in unsafe sex (I'm using 1990s terms here; as it was recently pointed out to me, I might be too old, and too stuck to be an effective youth counselor). Their doctor then starts them on a regimen of the same drugs persons with HIV take... the thought being, "hey, these cocktails and protease inhibitors might have be more effective if they're taken as a preventative measure... "Post-Exposure Prophylaxis."

(Believe it or not, some guys have no intention of engaging in safe sex and are medicated PeP... PRE-exposure Prophylaxis.)

Mark and I have been having a discussion, right here on Bilerico, as to younger gay men who take an HIV test.

Mark thinks its "brave."

I'm the Projector who's been responding: "It's not bravery. It's responsibility."

In 2006, Mark published a beautiful essay, which is posted on his website. Entitled Once, When We Were Heroes, it touches upon the madness of the late 80s and early 90s, when HIV was a death sentence.

What I think he's forgotten, though, is it wasn't Stonewall that made the gay "community."

It was HIV. It was gay men just automatically becoming care-givers. It was knowing by heart what hospitals would, and would not, accept a person with AIDS into their emergency rooms. It was being instantly awake when the phone rang at 2AM and knowing (this was pre-caller ID, remember) that another friend had died, and running down the list in your head of who seemed to be further along than someone else.

It was protests. It was learning politics. It was being beside a friend (or, sometimes, someone unknown to you) in a hospital room, filling in for some blood family member who should have been there... but refused to.

It was creating Shanti, of Aid for AIDS, or AIDS ProjectLA, or Gay Men's Health Crisis in NY, or AmFAR, or the Aris Project, or... the list would be miles long. Every metropolitan area of the country had their own little organization, donating time... money... food... medicines... whatever was needed.

It was finding the limits of one's own soul, while joining the collective soul of your contemporaries who were healthy.. simply by dumb luck.

It was the deaths of tens of thousands of people who forged this community. It was us, as a community, massed in hospital rooms, ERs, church community rooms, AA meetings, or just a bunch of guys standing around at the bars, comparing notes and horror stories, realizing our sexual appetites were killing us, and trying to convince others of that probable fact - only to be drowned out by the voices of those who never wanted the party to end, accusing us of being buzz-killers - that made us a community.

Fucking around without a condom is going to lead to one thing, within five years time: a repeat of the late 80s and early 90s, but on a larger scale. Hospitals and hospices will, again, be choked by our dying brothers. That nightmare - a person drowning on their own phlegm, their lungs eaten away by cysts... sudden madness as toxoplasmosis eats away at the brain... blindness as cytomegalovirus settles in... lymphoma that turn the skin into purple patchwork... sores that can't heal, open and suppurating.. loss of bowel and bladder control... dark, black liquid shit...

But, hell, what's all that if you can have a good fuck, now, right?

Getting tested isn't "brave."

Fucking around without protection is stupid.

Getting an HIV test is, simply, responsible.

Eric, I'm moved by yours words. I feel the depths of your concern for our young people and your desire to give them the knowledge to avoid the fate that so many in our community suffered. After working with college-aged people for the past eight years, one thing I have learned is that they often simply do not know and, to the extent they have some knowledge, they do not understand the significance of history. We must tell them over and over and over, so that at least some of them can grasp what they need to know to save themselves. They need to know that PeP isn't a preferred method of HIV prevention.

That being said, it seems to me also that explaining the importance of getting regularly tested, and the availability of PeP, and making these a positive experience, rather than something to be avoided like the plague, are all a part of saving our youth.

Eric Payne | May 30, 2011 12:31 PM

Thank you, Jillian. There's a segment of the community that never seems to get a voice - those of us in our 50s and 60s who are alive, relatively healthy, and HIV negative.

Mark's HIV status is public knowledge; hell, his blog is even titled My Fabulous Disease. I wouldn't presume to guess when Mark may have been infected, or through what transmission route his infection occurred. And that's [part of the history that seems to be forgotten.

It wasn't all that long ago that, in the public eye, there were those people who were suffering from some unknown pathogen that attacked the immune system, while at the same time, there were those filthy faggots dying of GRIDS. From the very beginning, because of moral judgments, instead of medical fact, there was a "victim hierarchy" established. There was GAY Related Immune Deficiency Syndrome, and there was some mystery pathogen affecting heterosexuals... and it couldn't, possibly, be the same pathogen.

There was the government, who valued style over substance to the point where style was substance. Dying queers simply weren't stylish - until one showed up at a White House function, a Hollywood "he-man" whose skeletal appearance at that function rattled the world.

There was the clear delineation of "innocent" and "guilty" in the public eye. Gays deserved what was going on - they brought down the wrath of God upon themselves... Hallelujah... ladies and gentleman our prayer lines are open, and if you want to make a charitable gift... - while Kimberly Bergalis and Ryan White were complete innocents, dying because of the wanton sexual acts of gays. It was us, dying in medical facilities where, too often, the medical staff would not even enter the room, while a scrawny, obviously ill, 20 year old woman testified before Congress about her evil homosexual dentists purposely injecting her with his blood...

(Long after her death, details of Bergalis' life were made public that sharply contrasted with the carefully created virginal persona shown to the public.)

She got days and days testifying before Congress about the horrors of AIDS; we were lucky if we got the Chief of Staff (or even receptionist) of the newest freshman Congressperson to talk to us on the phone.

We were told, then, it was our penchant for fucking around as much as we did that was our own death sentence - we needed to find one guy, and stick with him. "You need to be more like us," the moralists said, "committed to that one, special individual."

It was being legally evicted from your rented home. It was us taking in people, almost strangers to us, to crash on the couch.

It was the head of the CDC, Robert Gallo, to make his own name and reputation on being the discoverer of the pathogen, rather than instructing his department to work toward the destruction of the unknown pathogen.

Those who forget the past are doomed to repeat it.

My suggestion, as I've said before, make And the Band Played On required reading in high school. Invite those of us who are "elder" and healthy to address your students. Teach the history of venereal diseases (yeah, I know... I'm old... now it's "sexually transmitted diseases") in high school health class, the GOP and Christian moralists be damned. In fact, the sudden disappearance of a handful of students from that class could be an instruction point: Those people are gone from the class, dead to the class during class hours, because they allowed their thinking to override a physical health issue.

One thing that really pisses me off is that the need for testing. HIV is, above everything else, a sexually transmitted disease. It is 100% preventable. It's been over 25 years we've had that knowledge... and yet, HIV is still here whereas syphillis and gonorrhea, also STDs, were all but eliminated for decades... until HIV, that is.

I wanted to throw in the link to Mark's post, "Once When We Were Heroes." It completely deserves the praise Eric heaped upon it. Fair warning: have tissues ready.

I do not understand why "courage" and "responsibility" need to be mutually exclusive -- even though, ideally, we all live responsibly, that responsibility still sometimes requires courage, in and of itself. Living with integrity, demonstrating high standards of human character, often requires both responsibility and courage. In fact, in many instances I doubt that they can be meaningfully separated.

Eric Payne | May 30, 2011 10:36 PM

Because "responsibilities" are rapidly becoming extinct.

Borrow a car, run a stop sign and get into an accident? As can be seen on any of the daytime courtroom shows, the borrower fervently believes it is the car owner's fault for not carrying the right insurance.

There borrower doesn't think it's their responsibility, and is honestly shocked when judges rule against them.

Can't pay a mortgage? It's not the home-owner's fault, it's the fault of the predatory lender who, obviously, forced the homeowner to borrow the money.

Kids can't read, or do simple math, or speak correctly? It's not the parents' fault for not putting the time in with their kid, or the kids' fault for not cracking the books, but the teachers' fault for not being able to twitch their nose and impart that knowledge onto their students.

Drivers who can't be bothered to slow down in the rain... People who drive as if the freeways are some sort of NASCAR/Roller Derby mash-up...

When two people fuck, two people have the individual responsibility to protect themselves from possible infection, and a shared responsibility to inform their sexual partner - even if - hell, ESPECIALLY if - it's a one-nighter situation.

People who fall in to "high risk groups" have the personal responsibility to know their status, if for no other reason than to have peace of mind that that summer cough they've suddenly developed is simply a pollen allergy, and not PCP.

It might make a cute PSA to have someone claim bravery for having an HIV test; it certainly couldn't be worse than that PSA a few years back where a woman said: "As a woman, I thought I was safe from HIV..."

Not getting tested and not knowing your own status is shirking personal responsibility. Period. It's not brave. It's, simply, what a person needs to do and, in my opinion, should be treated as nothing but another aspect of an annual physical. If someone is sexually active, quarterly testing should just be... an automatic.

I mean.. c'mon... it's, literally, the difference between living and dying.

Yes, HIV-negative men who diligently try to do the responsible thing -- responsible to both themselves and their partners -- deserve praise. But HIV-positive men who try to "do the right thing" deserve praise, too.

And yes, I would call it courage: courage to insist you and your partner(s) use a condom when safety requires, courage to go in for the HIV test instead of "just not worrying about it", and the courage to do what Capitalist Piggy did after a "slip" -- so many men do not have the courage to face such headaches.

And finally, there are existential aspects of life that require all of us to practice a bit of courage. At some level, just making it successfully through life as a human being requires courage. Every day we live, every choice we take, opens certain doors and closes others.

Eric Payne | May 30, 2011 3:23 AM

You know, Jill, you could have called me by name, I wouldn't mind.

Bob Roehr | May 30, 2011 1:06 PM

Eric, I agree with much of what you said, but you are simply, factually wrong on two things. Robert Gallo was never the head of CDC, in fact he never worked there, he was a research scientist at the National Cancer Institute. That makes the rest of that comment irrelevant.

On the advice: "Here's a clue guys... if the condom breaks... stop fucking and put on a new one." That's fine to say and the way it should be done, but often it is difficult if not impossible for the bottom to tell if a condom broke. So, yeah, the top should have a better sense of what happened and act responsibily, but there are times when the bottom really is a victim here.

As for the assertion "What I think he's forgotten, though, is it wasn't Stonewall that made the gay "community." It was HIV." You are entitled to your opinion, but as one who was around prior to AIDS, I know there was a vibrant community prior to that and organizations and institutions that pre-date AIDS. Here in DC what is known as the Whitman-Walker Clinic had its roots in a group dating from the early 1970s.

Eric Payne | May 30, 2011 8:42 PM

You're correct, Bob. Gallo was the NIH scientist given the task of fighting this unknown pathogen, based on Gallo's bravado in claiming (before he'd done any research), that since some of what he was reading concerning possible routes of infection and subsequent "opportunistic" infections, it was his then-recently discovered HTLV-III retrovirus (Human Transmitted Leukemia Virus) that was the culprit.

It wasn't, and Gallo - despite his bravado - could never identify the culprit... until after the French did. And, surprisingly, the retrovirus Gallo later identified as "his" research was genetically identical to the virus the French had previously identified.

So, no, he wasn't the head of the CDC. I was working without my research materials when I made that statement.

He was the head - the scientific lead man - of what little research was being done at the time, and he was more concerned with his own personal ego than anything else.

I also agree with you about a bottom not being able to tell if a condom breaks, but I also just assumed (which I probably shouldn't) that so-called tops were aware that fucking sans condom can create friction sores on their dick, increasing their risk of infection through those friction sores. If either/any of the persons involved in the fucking notices the condom break... stop fucking and put on a new rubber.

Bob Roehr | May 30, 2011 1:46 PM

"and yet, HIV is still here whereas syphillis and gonorrhea, also STDs, were all but eliminated for decades... until HIV, that is."

That simply is not true -- unless you consider a half million cases of gohorrhea a year (1981), just among teenagers, to be "all but eliminated." http://www.cdc.gov/mmwr/preview/mmwrhtml/00001717.htm

Eric Payne | May 30, 2011 8:44 PM

Bob,

I wouldn't consider 500K cases of any illness to be "all but eliminated," but the Centers for Disease Control, at the time, did. I guess statistically, overall, those venereal diseases had all but dropped off the map - the big concern, in the 10 years before HIV, was herpes.

Either way, I don't understand why you feel a need to single out HIV-negative men as opposed to all people who are sexually active and HIV-negative.

Eric Payne | May 30, 2011 3:39 PM

Solely for simplicity.

Eric Payne | May 30, 2011 8:55 PM

Desiree Renee says:

"Either way, I don't understand why you feel a need to single out HIV-negative men as opposed to all people who are sexually active and HIV-negative."

I'm afraid I don't understand what you're trying to say here.

I speak of HIV-negative gay men and how the 80s and 90s affected us, because that's what I am: A gay male survivor of the 80s and 90s.

I speak of us gay male survivors as being ignored, because that's my perspective as a gay male survivor: The guys 10 and 15 years older than us are, for the most part, dead. Then there's those of us who simply got lucky. Then there's the ones just a decade younger than us who survived based on a combination of luck and the knowledge provided by the guys, just older than us, who died.

Then... there's gay youth. There's a whole new generation of gay men who love to have sex; they love their Tina and their cocktails (just as those gay men just a few years older than us loved their "blow," their amyl and their cocktails), and who don't give a lot of thought to what's going to happen tomorrow, let alone the day after, or the day after that.

I can't speak from the perspective of a bisexual person, or a transvestite person, or a transgendered person, or a transsexual person, or a suburban housewife, or a heterosexual teenager dating their first "true love," or a hooker.

If your experience is different - or even if (maybe especially if) it's not different - and you are not a 50-something gay male, I'm sure it would make an interesting, not to mention enlightening, read.

I'm not sure how I feel about calling someone "brave" who gets tested.

I guess it is an act of bravery on one level, and about self-worth, and valuing the lives of others as well.

I think it takes bravery to know you are HIV-positive and be honest about it with potential partners, knowing that some hookups will never materialize and some people will never want to date you. Much easier to just be blissfully ignorant, tell people you are negative, and infect more people.

There is some irony to the fact that many people put so much judgement on those who are HIV-positive, know they are, and are on medication. Refusing to have sex with them, even date- when in reality - the ones that are spreading the disease are by far the people who do not know they have contracted it, blissfully ignorant to the dangers they are spreading.

In a way the conversation reminds me of coming out. It is an act of bravery to get tested - because it is an act of truth. Telling one's truth, owning it, whatever the results- knowing that some will turn away from you.