HIV Loses. Love Wins. Again

Nearly all of my professional life has been focused on one goal and one goal only: To end AIDS.

Working at a lab bench trying to help develop an HIV vaccine. Engaging government officials worldwide about developing the best health policies to stop infections. Talking to community members about how to best take care of themselves and loved ones while still having fulfilling sexual experiences (pun intended). However like just about everyone else in my field, I had an active life before I ever worked for an AIDS-service organization.

After I finished school, I did not jump directly into the field of healthcare. I took all my academic biochemistry knowledge and used it to become one of the best mixologists, otherwise known as bartenders in Seattle. My main goal in life like other men in their 20's was to have fun. Work all afternoon and early evening at a local restaurant then head out to the local gay bars for a night of dancing and husband-hunting as my friends liked to call it. I drank too much, read too little and chased gay (and occasionally straight) men like it was going out of style.

While growing up and sowing my oats, I also took a microbiology class for fun at a nearby university. Yes, I was still quite the nerd and proud of it. In my class, I developed a crush on one of the other students named Michael. Of course, I did not talk to him because I was not that bold in my early years. Until one day while driving to class, he was standing on the side of the road waiting for the bus to campus. Not missing this opportunity, I made an immediate U-Turn, pulled up to him and asked him if he wanted a ride to class. Mike was a trusting soul so he jumped in the car.

As we drove, we chatted and laughed about the insecure pre-meds who were convinced that life would end if they did not get an A+. From that day forward, I would spend countless hours with Mike who was completely unaware of my crush. Mike was just over 30 years old and had grown up in the area. We talked each night about our studies and absolutely everything else as I would come over to his place every night with my leftovers from the restaurant. After exhausting ourselves with chatter, we would watch reruns of Star Trek since he was a major Trekkie. You will do just about anything if you are crushing on someone. After a few weeks of hanging out, he walked over to his cabinet one evening while I was rambling on about nothing, opened it, grabbed a bunch of pills and swallowed them without so much as a glass of water. I was astounded, but did not say a word.

We never discussed it directly, but it was clear that Michael was living with HIV. Even though I knew a couple of friends who were living with the virus, I really did not know anything about it except the basics that you learn in high school. Unfortunately, I went to a conservative Catholic high school that preached abstinence over comprehensive sex education; therefore, I was ill-equipped with the functional knowledge like so many other youth in our country. My college-prep school did not prep me.

Luckily, I was living in a gay-friendly city that plastered medically-accurate information about HIV transmission and treatment around town on billboards, club restrooms and on light poles. Medically-accurate information regarding sexual health is an exception to the norm in this country. Thus, I learned meds were much better at treating HIV and people were not dying from AIDS like in the mid-90's -- only a few short years earlier. And I also knew that HIV could not be transmitted without having condom-free sex or sharing needles. Other than that, I really knew nothing about it.

The best way to learn about any new topic is straight from the horse's mouth; therefore, I began asking Mike questions here and there about treatment. From our chats, it became even clearer that HIV had very quickly become a manageable chronic illness for those who had access to and took their medications.

In some ways, Mike was one of the lucky ones. On one hand, he faced less HIV-related stigma in Seattle from friends and healthcare providers so he had a great support system when he started taking his antiretroviral medication. And on the other hand, he shared countless stories of having lost nearly all of his close friends to the disease and eventually reaching a point where he just stopped going to the funerals of even his closest friends. Funerals had about as much meaning as a cloud rolling by. If he thought about his reality any other way, life would just be unbearable.

After the height of the AIDS epidemic, he also received his Positive diagnosis. And life went on as it always had for Mike. He did not have to immediately create a living will nor make funeral arrangements for himself. Mike was going to be just fine. He remained focused on other life goals: getting his college degree, supporting a parent with another chronic illness and buying property. And that's just what he did.

About a month of getting to know each other, I eventually worked up the nerve to ask him on a date. He said, "Yes." I was excited, but then came the reality that I would sooner (hopefully) than later be in a normal sexual relationship with a man living with HIV. School had not prepared me for this aspect of my life in the slightest. So I studied a bit more. Of course, I avoided those conspiracy theory websites that assert HIV was created by the US Government and that aliens killed JFK. I just focused on the facts. As a bartender, I was not well trained on risk reduction. I looked at reputable websites, chatted with friends who were living without HIV who had dated men who were living with HIV and even engaged my mother. She clearly was not ready to talk about my sex life on any level, but she listened. Bless her heart.

Mike and I began having sex regularly. There was no PrEP and no PEP in those days, the meds that prevent HIV infection either taken before exposure or afterwards. In our relationship, we used condoms and lube each time. That's what worked best for us which may not be true or available for everyone. We were lucky. I was the Top in our relationship and knew that Tops (insertive partner) are less likely to become infected when the Bottoms (receptive partner) are the persons living with HIV if the condom broke. We had oral sex without condoms. It seemed clear to me that the chances of transmission orally were slim especially since we had both tested Negative for other STDs like syphilis and gonorrhea which greatly increase the ability of HIV to be transmitted.

What we did not know then that we should all know today is that HIV transmission was nearly impossible. Why? Cause Mike was consistently on treatment. As one researcher phrased it, "there is no direct evidence that it is possible for HIV transmission can occur when the viral load is below 200 units/ml." Simply put, a person - who is taking their meds as prescribed and those meds are working -- actually cannot transmit the virus through sexual encounters. This phenomenon is known as TasP, or Treatment as Prevention. TasP should have made sense to the world a couple of decades earlier. HIV is not different than any other virus like the common cold. When it is under control with medication, the person is no longer contagious. Those people who assumed this to be true years ago were exactly right.

Mike and I carried on like any other couple. We had fun. We laughed. We argued. He got in trouble for not getting me a Christmas present. He suffered through watching NFL Playoffs and Duke basketball games. I suffered through watching nightly Star Trek (Original and Next Generation) reruns in addition to movies. We were your standard gay couple. HIV did not define our relationship. No time for stigma. It did not have any power of us.

In the world of HIV Prevention, a lot of attention has been focused on the pill that can prevent HIV infection called PrEP. It has been often heralded as the drug that may finally help us beat back new HIV infections worldwide and End AIDS once and for all. That is more than exciting news, but it is not the only amazing news about stopping our generation's plague in its tracks. TasP is the absolute game changer for everyone whether they are living with or without HIV. And so you know, I reached out to Mike the other day and he let me know he is doing superbly well and that he and his husband just celebrated their 9th year together and recently got married -- thank you U.S. Supreme Court!

HIV Loses.

Love Wins.