What everyone should know about HIV

Do you have all the facts?

I often get contacted by people on Facebook or Twitter asking me about HIV, either because they’re curious or believe they’ve put themselves at risk and need some reassurance.

I’ve always been very open about my status, and I’m glad people feel they can ask me instead of sitting there stewing. But it’s become increasingly obvious to me recently just how many people there are out there who know almost nothing about HIV. I’m not judging anyone, just making an observation.

You may remember a while back I wrote a post called ‘Why we should never stop being scared of AIDS’, and I stand by that sentiment. You should be damn scared of AIDS — it may be a manageable condition nowadays, but it sure ain’t fun — but there’s a difference between those who fear it because they’re ignorant, and those who have the facts, protect themselves and still have fun.

So I’m going to give you the basics. I’m not a doctor, so this isn’t written with the education of someone with a medical degree. I hope I’ve managed to slim down the technical side of things without compromising accuracy, but I’m quite happy to be corrected if you want to leave a comment.

This blog has had over half a million visits in the past year. If I can make just one of those visitors think twice about taking risks, then I may well have saved a life.

So here we go:

The science bit:

HIV’s a clever little bugger. When it enters your body, it targets your white blood cells. There are many different types of white cell, and they don’t just live in the bloodstream. But in very simple terms, they’re your immune system — the more of them you’ve got, the healthier you are.

HIV latches on to the white blood cell and empties its DNA into it. In doing so, it effectively turns the cell into a factory for producing more HIV — when the white blood cell reproduces, so does the virus.  Sneaky, huh?

But it gets sneakier. When HIV copies its DNA to human DNA it makes a small ‘mistake’ and mutates ever so slightly. This is why it’s so hard to find a cure — because by the time we develop one, it’s irrelevant because of how much the virus has changed.

If you imagine the yearly mutation of the flu virus to be the size of an A4 piece of paper, HIV’s equivalent could arguably be a couple of football pitches.

How do I know if I’ve got it?

Well, the simple answer is — you can’t. Not without a test. Once you’re exposed to the virus, your body will try to produce antibodies to fight off the infection. It’s the presence of these antibodies that the doctors look for when they test you for HIV, but it can take anywhere between thirty and ninety days before there are enough of them to detect in a test.

Some people will develop flu-like symptoms a couple of months after infection. Others may not show any symptoms at all. My experience was pretty traumatic. I was so weak I couldn’t even move, I barely ate. I lost nearly two stone and I had a blotchy red rash all over my body.

Attractive, huh? Thinking twice yet about barebacking?

PEP

It stands for post-exposure prophylaxis — and it could save your life. It’s basically a course of HIV medication that you take for a month after you’ve been exposed to the virus, and it could cut the risk of you developing HIV by around 80%.

But you need to be quick — you’ve got about a 72 hour window after exposure to get the treatment (the HPA in the UK say ideally within one hour and not beyond 72 hours). You can get it from Accident and Emergency or through selected GUM clinics. Have a Google and you can usually find where to get it in your area.

Accidents happen, condoms split or get forgotten in the drunken, drug-fucked heat of the moment. Nobody at a clinic is going to judge you, they just want to help. But make no mistake; this is not some magic ‘morning after pill’ — the side effects can be gruesome, and can include heavy vomiting, diarrhoea, nausea, insomnia and dizziness — but it’s better than the alternative. It might be a second chance at an HIV-free life.

So don’t blow it — and take a bit more care next time.

So what should I classify as safe sex?

There are certain activities which can be said to be lower risk than others. Oral sex, for instance, is a lot lower risk than penetrative sex. But the actual risk is dependent on a number of factors.

For instance, if you have oral sex with someone who’s got a high viral load and is highly infectious, that’s obviously going to be a greater risk than if, like me, they’re undetectable (I’ll explain what that means in a second).

On the flipside, they could be undetectable, but if you’ve nicked your gums when you dashed to the bathroom to brush the taste of vodka from your mouth before you got down to it, then the risk goes back up.

And whether you’re male, female, top or bottom, barebacking’s a no-no. Just stick a bloody condom on. You may think you can’t catch it from a passive partner, but you can, and you probably will. If you rupture something while you’re banging happily away up there, you’ll be absorbing the virus straight through the head of your dick.

Nice.

So should I avoid sex with someone who’s positive?

Sex with a positive person — as long as it’s safe — shouldn’t be something to be frightened of. If they’re kind enough to tell you beforehand, you should assume they are in control of their health, and are at the right stage of their treatment, and therefore won’t do anything they feel will put you at risk.

However, you always have a choice, and it’s your decision whether you have sex with them or not. Don’t just go with the flow’ while silently freaking out.

I’ve been turned down by countless guys because of my status, but the one thing I always say is: “I’m not the first positive guy you’ve slept with — I’m just the first one who’s told you.”

So why should I get tested?

Well, apart from the obvious peace of mind, there’s another thing to consider. So here’s science lesson number two:

There are two indicators of how an HIV+ person’s body is coping with the virus:

• CD4/T-cells: It’s a little complicated, but they’re pretty much the same thing. T cells are a type of white blood cell, and CD4 is the protein on a T cell’s surface that the HIV binds to. For this reason they’re sometimes known as CD4⁺ T cells. A healthy person can have a count of anything between 500-1500 per drop of blood.
• Viral load: This is the number of copies of HIV per drop of blood and can vary wildly. At my worst, it was over half a million. Now I’m on drug therapy, it’s below 50 — or in clinical terms ‘undetectable’

So therefore, high CD4+low viral load = good news. When the CD4 drops below, say 250, this usually indicates the immune system has suffered damage, and then it’s usually time to consider drug therapy.

So if you don’t get tested, you won’t know if you’ve got HIV, and if you’ve got it, how the hell can you know how your body is coping with the virus? The longer the virus goes unchecked, the more it’ll have the chance to damage your immune system — and that’s where the trouble starts.

Also, the higher the viral load, the more infectious you are to partners — even if you’re indulging in relatively low risk sex.

You may not need to go on meds straightaway. I didn’t start taking them until I’d been positive for six years (I was diagnosed eight years ago). In fact, my CD4 was still around the 1000 mark, it was just that the virus was multiplying exponentially, and it was time to bring it under control — I looked awful, I was about two stone underweight, I was ill all the time, eczema, night sweats, diarrhoea, the lot. I was quite glad, actually.

In a nutshell

Well if I haven’t hammered the point home enough already, I’ll just say it one more time:

Go. Get. Tested.

And if you feel you don’t know enough about HIV, make it your mission to learn about it. You can find out a lot about HIV from websites like AIDSmap, or from charities like GMFA or Terence Higgins Trust.

You may think it’s one of those things that just happens to other people — like a house fire or car accident. But it’s not. It’s real and it’s on your doorstep.

Knowledge is power as they say. And the more people who take control of their health, the better. There is no cure, but with the right care you can live a long and happy life.

I’d like to think of myself as living proof that having HIV and having a fucking great life aren’t mutually exclusive, but if I hadn’t got myself tested, there’s a good chance I wouldn’t be here now, and I wouldn’t have had the chance to experience all the amazing things life has sent my way.

Thanks for reading.

Guy, Interrupted

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