There is no reason in 2017 to find out you are HIV-positive only at the point that your immune system is already seriously damaged.
I say that as one who has “been there, done that.”
Although I thought my doctor was testing me for HIV every year when I went for my annual checkup, we both found out in 2005 that, for some reason, he had no record of a test for the previous two years. I was not expecting him to open his follow-up call, three weeks to the day after I turned 47, by saying, “I have bad news on the HIV test.”
Since my first negative test, in 1988, I had taken what I considered to be calculated risks based on what I knew about HIV transmission, the sexual activities I engaged in, and the partners with whom I did or didn’t do particular things. Over the years, however, my calculated risks expanded to the point that I was able to justify topping someone without a condom. I reasoned that the risk to me was low even if he was positive. I know from conversations with gay friends that my rationalization was hardly unique.
Unfortunately, low risk doesn’t mean no risk. And this is how I believe I got infected with HIV, well past the age when I used to think men should “know better.”
After a second, rapid HIV test in my doctor’s office proved even to a skeptical journalist that I was now HIV-positive, I also learned that my immune system was in bad shape. In fact, the T-cell count of 198 meant I had an AIDS diagnosis, the clinical term for late-stage untreated HIV infection. I’d had no symptoms whatsoever. It’s likely I would not have known I had the virus until something terrible happened.
“This is so eighties!” I said to my doctor, recalling my friends and so many other gay men who didn’t know they had HIV until they were deathly ill.
Today, nearly 12 years later, I am living well with HIV—thanks to effective medications, the care of experienced doctors, a healthy diet and exercise, and the power of knowing my own resilience.
This is why I am here to tell you: Be proactive. Get tested. It is far better to know what you have to deal with than to be blindsided, as I was.
Unfortunately, many gay men still are blindsided. They don't find out they're HIV-positive until they become deathly ill. They avoid knowing their HIV status because they haven’t yet found within themselves the ability to defeat the shame so many still insist on attaching to this particular microbe.
The Centers for Disease Control and Prevention (CDC) reports that at the end of 2013, 687,800 gay and bisexual men in the United States were living with HIV. Of those, 15 percent were unaware of their infection.
People who don’t know they have HIV can’t get the medicines they need to stay healthy and reduce the likelihood of transmitting HIV to their partners. This means they may transmit the infection to others without knowing it.
For all of us, testing and knowing our HIV status is a testament to our resilience—we are strong enough to handle the information—and an important contribution to our community.
“Testing is a way of bringing gay men into the community, to feel like their community cares about them,” said Fred Swanson, director of Seattle’s Gay City Health Project, in an interview for my book Victory Deferred: How AIDS Changed Gay Life in America. He added that HIV testing, “is underutilized in our communities as a connection opportunity and a way to get guys involved or even just thinking about why their community matters.”
Of course you can buy and take a home HIV test, or you can be tested by your personal physician or at a public health clinic. You can find a testing site in your area here. Many choose not to get the test from their doctor because they are concerned that a positive test result could get back to their employer or harm them in some other way. Be advised: If you test positive, your doctor and public health clinics alike are required by law to report the result to the state public health department; forty-six states require confidential name-based reporting.
Where you get tested is up to you. The main thing is that you get tested.
Activists and people living with HIV have understood since the beginning of the HIV-AIDS epidemic that knowledge is power. Silence—and not knowing your current HIV status—can still, in 2017, equal death.