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Thursday, 1 December 2011

My World Aids Day Speech

I’m Rich. Im 35 and have been living with HIV for 2 years now

I have really struggled with this talk.

Initially I thought I would be able to come up with something to say that showed me as a strong and hardy man. A person who had faced his demons, looked them in the eye and come out on the other side a stronger and wiser person.

Initially I felt being a positive speaker was all about putting a positive spin on being positive.

Initially, I wanted you all to like me. To see me as a beacon of hope and strength and as a person who was making a difference.

But that is not what this is about for me. This is not the reason I am being a positive speaker. I don’t want you to either like or dislike me. I just want to say what it is like, for me, to live with HIV.

I wrote a draft speech, which on the surface I was very happy with. But in reality it contained everything that I felt you guys would want to hear and nothing about how I really felt on the inside.

You see, in all honesty, I don’t think I have yet fully come to terms with being HIV positive.
In all honesty, I don’t think I have even started to come to terms with it.
In all honesty, all I have managed to do for the past 2 years is lie to myself that everything is going ok and that I have not really been affected by my status change.

Don’t get me wrong. I am not in denial
I know I have HIV. I am reminded of it every day in one way or another.
Every time I take my meds.
Every time I think about having sex with my partner, who is HIV negative.
Every time I visit my kids or speak to them on the phone.
Every time I meet  new people.
Every time I apply for a job
Every time I feel slightly under the weather
Having HIV is a fact that sits in the back of my mind and whispers and niggles at me continuously and it never seems to go away.

Don’t get me wrong. It is not that I don’t understand what HIV is. I grew up in the don’t die of ignorance era. I had the lectures off my mother. I saw all the news stories and have studied virus physiology in depth during my biochemistry degree. I know how it works from an intimate perspective.

Don’t get me wrong. I also know how I acquired HIV. Another fact which, up until I came to write this speech, I felt was irrelevant. I would like to say that I don’t regret my behavior which lead me to becoming positive but, in all honesty, I do!

You see, I felt so deeply unhappy with myself, in so much pain and self loathing that I went out to punish myself. I am not one of those guys who was lied to by his partner or who made a silly drunken mistake.  I am not one of those guys who played safe all his life and acquired HIV through a broken condom  or oral sex or a needle stick injury.

I took risks. Reckless, uncautious, careless and irresponsible risks.  I took these risks in full knowledge that I would probably ends up wit HIV but I was trapped in a mental state of mind that it was going to happen eventually anyway so it did not matter.

I found myself immersed a hedonistic world of endless sex and partying. I worked on the gay scene in a sauna so was constantly surrounded by sex. Most of my friends were HIV positive and preferred to have unsafe sex. So the inevitable happened. But me being me, I managed to not only get HIV. I also was diagnosed with Hep C at the same time.

So who had I got both virus’s off?
I don’t know. It could have been any of many
And actually, the only person who was really responsible for my acquisition of both these virus’s was me.
Do I regret this decision? Yes
Do I regret my behavior? Yes
Do I wish I had gone about things differently? Very much so!

But regrets are irrelevant right?
They are the signs of a weak person?
They show that you are not accepting the consequences of your actions.
Of course they do, that’s why they are regrets and anybody who says that they have no regrets is a liar. It is normal to go through the “what if” scenarios. To look at the colour of the grass on the other side of the fence. To imagine how things would have turned out if only you had made a different decision. 

The news of the double diagnosis hit me hard.
I had got what I asked for and there would be no going back.
The following 18 months of Hep c treatment. Going to the clinic every 4-6 weeks.
Dropping out of my PhD as a result.
Working as a escort to help pay my bills
The depression. The weight loss. The mood swings.
Pushing my family and friends away

A year into my diagnosis I was 50 kilos. I had lost over half my body weight. I could not eat much and had constant chronic diarrhea. I could not concentrate on much, was constantly tired and to be honest, I was about ready to give up.

In the space of a year I had gone from a first class graduate and PhD student. A lively and vibant man on track to an exciting career in academia to a weak, sick, skinny rent boy living in a squalid cold bedsit in Liverpool.

The decision to start me on meds sorted my body out.
The Man who I share my life with now sorted my mind out.
Without these two things I really believe that I would not have made it into the new year.

I am a dad
I have 3 amazing kids
They do not know I have HIV
They do not need to know as they are too young and at the moment my HIV is not making me ill and my meds give me no side effects.

They did know about my Hepatitis. But this was while I was on my treatment and underwent dramatic weight loss and mood changes.

Being a Gay dad in itself throws up its own interesting set of questions and puts you in a powerful dichotomy. You want to go off and live the care free, glossy magazine hedonistic gay lifestyle. The bars. The clubs. The holidays. The sex. The drugs. But you also have to keep a foot firmly planted on earth. To be a responsible role model for your kids. My decision to take both feet off the ground and dive into a purely gay lifestyle for a while back in 2009 was based on my own selfish need to run away from all the problems in my life. Historically I am very good at this. Running away. I recognize that now. I think deep down I can be a very selfish man.

I would have liked to have thought I was gonna be this strong man up on the stage spouting how i had overcome adversity and stigma and held my head high… but i think the reality is that I have not yet properly dealt with being positive yet. I feel strong and i come across like it isn't bothering me but deep down i know that is just a clever deception

The man I am today. The Rich you see before you is a very different person from who he was a few years ago.
On the surface I seem to be a lot more confident.
On the surface I seem to show that being HIV positive does not affect me
On the surface I appear to be an open book and that my life is on display for all to see.
On the inside I am seriously messed up
On the inside I have really started to stress and worry and care what others think of me
On the inside I am very scared and insecure

I find it easier to talk about other peoples problems.
To offer strength and support to everybody else who is in a crisis
To give guidance to those who seem to have lost their way.
I find these things easier than having to sort out my own problems. That would require me to acknowledge that there is something wrong in the first place.
I feel that getting up here today and telling you all this is my first step to really coming to terms with my status. For once I have stood up and acknowledged to myself that I am not alright and that it is not all a bed of roses.
But do you know what.
It could be a lot worse.
I have a great man who loves me
I have 3 kids who love me
I have some amazing friends who love me
I have everything a man needs to help me get through any problem.

I feel that I have found a place in a community where my voice does make a difference. I am not ashamed of being positive.
My positive attitude towards HIV and the fact that I am so open about my status does seem to have resonated with many others.
The blog that I write, while it serves the purpose of providing information to others about living with HIV is also in a way quite cathartic for me.
And recently I have started to volunteer for THT.
Right now I look after myself. I eat well. I work out. I drink and smoke less. I have never looked after my body so well as I do now. Is that just my age or is it the knowledge that I have a life long chronic illness? It does seem a bit sad if it is the latter. I mean, why does it take a virus to make me look after myself better? Go figure.

I am horrified at just how ignorant many still are about HIV and how there is still such a stigma attached to something which has been around and in all our lives for 30 odd years. It is the stigma which I seem to have focused on most in the past 2 years. Probably from my own fear of being judged. The way I see it is if I can make everybody see that HIV is not something to be feared and that is it just a fact of life for us all then it will prevent me from having to go through the pain of rejection, isolation or being shunned. Fortunately I live in the UK. I don’t think my liberal attitude and open expression of my status would be looked on in the same way in many other countries across the planet.
I think I was foolish to believe that coming to terms with being positive was a quick and easy process but feel that after today I am a little bit closer.

I have recently had a phrase tattooed onto me:
What doesn’t kill us makes us stronger.

HIV most probably isn’t going to kill me.

But is it making me stronger?

I don’t know. But there is something about the phrase that gives me hope. 

Monday, 21 November 2011

Sex and SeroDiscordancy for Positive People

One of the biggest dilemmas and hurdles facing both newly diagnosed and many long term diagnosed positive people is the question of sex. After all, HIV, in the majority of cases, has been transmitted though some form of sexual contact. As a result I have seen many people go through long periods of celibacy. When I have asked them why they are not having sex any more the answers are invariably one or several of these responses:

1.     I don’t feel very sexy any more
2.     Its sex that got me into this situation in the first place!
3.     I have lost my mojo
4.     I am worried about giving this to somebody else
5.     I am scared of being rejected so its easier to not bother trying
6.     Whose gonna want me now anyway?
7.     I feel dirty and tainted
8.     I don’t want to talk about it

Given the circumstances, most of these responses are pretty understandable. I mean, nobody asks for HIV (Apart from the bug chasers, but that’s a different story), so coming to terms with having a sexually transmittable long term condition is going to, at least in the short term, give you a sense of apprehension and almost phobic response to any sexual activity.

So how do we get over this hurdle?

Because positive people can and do go on to have very healthy sex lives and normal, argumentative, bickering, loving, sharing, monogamous or open, committed, understanding and passionate relationships. The kinds of relationships that they were having before they acquired their little additional passengers.  The difference is that they are on the other side of the equation now. Before hand, it was their responsibility to protect themselves from acquiring any STI’s. Whereas now, they have the additional responsibility of not passing on the one we which know we have. The prospect of infecting somebody that we love, a soulmate, a life partner or a spouse can become such a burden for some. But what we forget is that it is not just our responsibility to try and prevent the spread of HIV. It is everybody’s, and that includes our partners, though this little fact does not always help or seem apparent. Being in a relationship with a HIV negative partner therefore can be strained to say the least. This dynamic is called “Sero-Discordancy”. In an earlier blog I talked about SeroSorting and how some positive people choose to only have sex with other positive people.  This decision is not always quite so easy or straightforward. What if you find  “The One”? What if you meet that person who presses all the right buttons, makes you want to hold them all night, fuck them senseless all day. Makes you laugh and feel totally at ease with yourself and accepts you for the person that you are.

What if that person is HIV negative?

At what point do you tell them that you are positive. Will this ruin the relationship?
At what point will your discordancy of status start to cause problems in the relationship?
At what point will you give them the virus, infect the person you love?
At what point will you start to get ill and will they have to watch you die?
At what point did you become so worried about what if’s and maybe’s?

We can drive ourselves insane trying to think of all the possibilities and eventualities. The simple fact of the matter is, if you love each other no obstacle is great enough and no hurdle is high enough for you to deal with. If you are right for each other then the fact that one of you is HIV positive is besides the point. Having HIV does not make you any more or less of a person. It does not make you a different species. It does not make you any less human. The only thing that should matter is that you trust each other and understand the boundaries that you are both going to set and the risks that you are both prepared to take, as a couple. This way you are both going into the relationship with your eyes wide open and with a shared sense of responsibility for the possibility that the negative partner may at some point acquire the virus. Of course, how you manage the risk is between the two of you.

Transmission risk is not the same for all sexual activities. The most successful approach to date is to always use a condom, but there is still the risk of the condom failing or the “Drunken/off your face, OMG we fucked without a condom” scenario. The risk of transmission is also different dependent on if you are a top or a bottom (Of course straight couples don’t really get much of a choice in this decision). Whilst penetrative sex is a high risk activity whether you are a top or a bottom, the risk of transmission is greater for the receptive partner if he is negative and the top is positive. Don’t go thinking that you are free from risk if you only Top, your bell end is capable of directly absorbing the virus! All I am saying is that the risk of you getting the virus by topping is lower. This risk is significantly reduced even further if the Positive partner is on anti-retroviral meds, is adherent and has a sustained undetectable viral load (the amount of virus floating about in his body). However, there are still studies going on to determine if there is a correlation between blood viral load and the viral load of other bodily fluids such as Semen for example. Of course, sex doesn’t just have to be about the pokey bum fun though does it. There are plenty of other things which are even lower risk or risk free for HIV transmission that a serodiscordant couple can get up to. There is  oral sex and fisting, which both carry a massively reduced risk but in addition I am not going to go into a big list of non-penetrative role playing and BDSM activities. I’m sure you all have a pretty good imagination. The point I am making here is that there are many ways you can continue to have a very healthy and active sex life as a HIV positive person with a HIV negative partner (S).  Be that through safe sex or through managed risk, Don’t become a Monk or  a Nun just because you are poz, lifes too short and just think of all the great sex you will be missing out on!

Wednesday, 19 October 2011

Bug chasers and BareBackers. If you like a lot of chocolate on ya’ biscuit join our club!

This blog is by no means a way for me to glorify being HIV positive and in no way am I suggesting through the scope of its content that deliberately seeking to become infected with HIV is a sensible or solely beneficial choice. What you are about to read is merely a balanced viewpoint of some of the aspects of living with the virus and how it is not necessarily all doom and gloom. We all make choices in our lives, for whatever reasons at the time and as a result have to live with the consequences of our actions. Barebacking, stealthing, breeding, gift giving and bug chasing are things that are happening around us all every day. They may not be talked about much but that does not mean that they are not happening.

Being a member of a club brings with itself a certain feeling of exclusivity. It makes the members feel special in their own way. The rock climbing club; The golf Club; The MX5 owners club; The gentleman’s club; The FreeMasons; The swinger club. You get the idea. We like to associate with others with the same interests, the same outlook on life, the same goals and life experiences. This is a basic foundation of social structure. As with many clubs a membership is required. Sometimes this is free, sometimes there is a price to pay and sometimes you need a certain possession or attribute. The main point is that people like to be in a club because it gives them a sense of belonging and a feeling of solidarity with the other members.

When I was first diagnosed with HIV several of my buddies came to see me to offer support, to make sure that I was not freaking out, to give me a big hug and to “Welcome me to the Club”. Now this last item may seem like a bit of an odd thing to do. How can having HIV be like being in a club? Just what benefits does it give you? For one, there is certainly a price to pay on a psychological, physical and social level. Looking back it was almost like I had been through some kind of initiation. No pledges of allegiance or swearing on a bible, just the fact that I no longer was part of the HIV negative community. A tiny, microscopic biological particle had caused a huge change in my life. Life being a very important word in that sentence, because the very nature of this virus was that it could weaken you to the point where you would die. So on this point there is certainly an attribute required to be in “The Club”. Being Positive! But this expression extends much further than the obvious ramifications of having a disease.

Many guys I know do not use condoms and have never used them. This term is known as barebacking. Some see this as an irresponsible thing to do as it can lead to transmission of sexual infections and diseases, but between consenting adults it is perfectly natural. Heterosexual couples bareback all the time and in fact, if they didn’t we would soon have a bit of a population problem! Penetrative sex without physical barriers is as intimately and physically close as 2 people can get, which is one of the reasons the pill, coil, cap, vasectomy and contraceptive implants/injections were created in the first place. If condoms were the only form of contraception available on the planet there would be a whole lot more than 6.8 billion people here! So, why are gay men demonised so much for having unprotected sex? I would say the main reason is because we are such promiscuous fuckers! Men like to have sex. Men like to have sex with as many partners as possible. Men think about sex all day long. They look at other peoples arses, genital areas, lips, chests. They talk to each other about sex, what they did, are going to do, want to do. This is as true for straight men as it is for gay men and though we are human and have higher a state of consciousness and morals and free will, essentially we are just walking loaded weapons of DNA looking for as many targets as possible.

In the straight community this desire is contained somewhat because of the social control structures and mechanisms that have been put in place by tradition and religion. These controls were created to foster stable family environments for the resulting offspring created by the barebacking straight couples. Marriage and monogamy are seen as both normal and as desirable. Gay men cannot have biological children as a result of their sexual encounters and as such are less influenced and controlled by these measures. I am in no way saying that a gay couple is incapable of having a loving, committed and monogamous relationship. How people choose to have their relationship is between them. The chances of a gay couple being open to additional sexual partners within the realms of their relationship however is, in my experience, significantly increased. Anyway, I digress. The point I am making here is that gay men do not have to obey the regular rules of relationships set by society and as a rule we don’t! The amount of Sauna’s (Health clubs where gay, Bisexual and “straight” men go to fuck each other), Fuck clubs, cruising grounds, cottages, internet hook up sites and mobile phone apps out there will clearly demonstrate just how open and liberal men are when it comes to sex and promiscuity. Men cannot impregnate each other and so unprotected sex on the surface has a lot less long term implications. During the 80’s and 90’s HIV was a much more scary prospect. Treatment was still in its infancy stages and carried a lot of debilitating side effects. This one factor was enough to cause many guys to rubber up and have safe sex. But with modern treatments HIV no longer has the same scare factor that it once did. Guys still love to have unsafe sex and the consequences seem less threatening. Becoming HIV positive in 2011 no longer is such an ordeal. The social, professional and peer support networks available now are amazing.

For some, myself included in this group, the choice to have bareback sex was partly fuelled by this modern day perception of HIV. Many porn producers are bareback only and use porn models who openly advertise that they are HIV positive through biohazard tattoos. Many fuck clubs are geared up towards bareback sex with members comparing how many loads (of cum up their arses) they have had or how many guys they have bred (fucked and cum inside of). Some poz men openly talk about their status during sex. So called “Poz Talk” is another way for guys to eroticise and fetishise their status. Much like a straight guy might say “I’m gonna fuck you hard you dirty bitch” (coming over all butch there, I have little idea of what straight couples say to each other while they are fucking, correct me if im wrong here lol), poz guys may say things like “Take my poz cock up your arse” or “You want my toxic load”. Being on the other side of the equation now however I have been approached by negative guys who ask me to Breed them with my poz load. Sadly for them, this is not my bag and even if it were, being on meds and having an undetectable viral load makes it virtually impossible for me to pass on the virus. Feel free to read : http://www.aidsmap.com/page/1429357/ for information on how the Swiss now deem HIV positive men with a  sustained undetectable viral load of 6 months and no other STI as non-infective for HIV.

For HIV negative guys the anxiety of potentially becoming positive can be overwhelming and so when it eventually happens, which in these scenarios it inevitably will, there is almost a sense of relief. The worst has happened. I know guys who have deliberately become Positive because it will gain them access, as a positive man, to proper health care and attention for other pre existing medical problems. Bit of a drastic step you may think, but sadly, certain components of healthcare in the UK such as mental health, are seriously overlooked and neglected. Having HIV can ‘up’ your priority on the so called urgency list for treatment and effective care.

Some guys actively seek out HIV positive men to have bareback sex with so that they can increase the chances of becoming infected. This is called bug chasing. Some eroticise the risk of having this kind of risky sex. Bug chasing can stem from a lot of other different reasons also such as self punishment and depression or the desire to just be “in” the club. The guy passing on HIV knowingly to a negative guy is ironically called a “Gift Giver”. Yes, I know what you are thinking. Surely this is illegal. Surely it is GBH or ABH or something and yes, you would be right. But downloading a movie from PirateBay is illegal too, doesn’t stop people doing it. Some gift givers however pass HIV onto non-consenting negative guys. This can be by lying about their status or pre damaging a condom with a needle before they use it. This is called “Stealthing”. Just because a guy tells you he is negative it is not always the case. Just because a guy uses a condom it does not mean you are 100% safe from infection. Oh if only the world was so straightforward! Now don’t go getting all alarmed by this last piece of information. Many positive guys are terrified of passing on the virus. For risk of prosecution and also because they have had such a rough time coming to terms with being positive themselves that they would not knowingly want to put somebody else through it too. I’m just letting you know that such things happen. If you are negative and wish to remain that way and manage your risk by using condoms then always use your own. I’m gonna wind this up here for now as I need to go cook tea but I want to expand a bit more on this concept of being in a “club”

Laters guys…..

Wednesday, 12 October 2011

Oral Sex: Its great to Suck but don't be a Sucker

Ok, so I have established that I am very open and outspoken about my status but what impact does this stance have on my life? How does being so frank affect me on a day to day basis?
Some people have said I am stupid for being so forthright, that it will bite me on the arse at some point down the line.
Some say I am courageous and wish that others were as open about being poz as I am. 
Some say im being too in their face and that they don’t want to hear about it.
Others say thank you for sharing and that they resonate with what I am saying.
As for me? What I say is that I need to be like this. I need to be this honest with myself and others. It is one of the biggest and best mechanisms I have come up with for me as an individual to fully come to terms with and accept being HIV positive. And whilst I care what others think and value their opinions, nothing anybody says is going to quell my voice.

Last week I had an interview with Terrence Higgins Trust, a HIV charity set up in the name of one of the first individuals to die from an AIDS related illness. Their mission is to promote safe sex in the community and to offer a support network for those who are living with the virus, affected by HIV or struggling with their diagnosis. The role I was interviewed for was health promotion outreach. This involves going out into the community, to target areas such as bars, clubs and cruising areas to offer some support and advice to people about their sexual health. Now in your mind I can see you envisaging me as a safe sex police officer dishing out condoms like sweeties to all the drugged up, loved up, horny or drunken gays before they go to the sauna or into the woods or into a toilet cubicle or take some lucky guy home. Maybe this is your own personal experience of health promotion outreach: “If I nod politely and say yes in all the right places and take a few condoms off them they will hopefully fuck off in a minute”….. I know, I have been on the other side of this so many times myself. On the surface it seems like such a thankless job. Anyway, they loved me! They appreciated my frankness and candor and have enrolled me onto their core training next weekend!

I am hoping to turn this perception of health promotion on its head a bit. The fact that I personally choose not to use condoms when I am having sex slips a touch of irony into me doing this role. But in my head, the role is about sexual health promotion and is not just as a glorified condom vender. Being responsible for your sexual health does not just involve sticking a condom onto your cock every time you want to stick it into another guy. Oh if things were only that simple! If that was the case there would be no need for HIV charities in the first place! For example. Do you use a condom when having oral sex? This is a common question asked by doctors in the GUM clinic. Now if every man being asked this question were to be honest then the answer 99.5% of the time is always going to be NO! Come on, just how un-erotic is sucking on something that tastes of condom??? You may as well stick a dildo down your throat! I mean, sucking on a cock after a condom has been on it is bad enough! The reason that this question is asked however is because there is a very small chance that there is a transmission risk for HIV from oral sex. Now the risk is present if for instance one or a combination of the following factors are present:

A.   You have tonsillitis/sore throat/inflammation etc, in which case the odds that you are going to want to have a cock rammed down the back of your mouth are slim anyway.
B.   The guys cock has lots of scabs, cuts, warts or open wounds all over it. Not very appetizing to say the least!
C.   You have just brushed your teeth and have bleeding gums.. Oh come on, yeah, im in the sauna and have just popped to my locker to brush my teeth before I go cock hunting in the steam room!
D.   You swallow several pints of semen. If somebody can find this please let me know!
E.   The guy is bleeding from the end of his cock because he has a different STI, bladder infection or prostate cancer. All you Fang Banger True Blood fans are welcome to go for it.

I am not an official authority. I am not a doctor. I am not a GUM health care support worker. However, I am a sleazy gay biochemist, with more than a little common sense and passing understanding of HIV transmission. Sucking on a cock, provided points A-E above do not apply, is pretty much as safe as it can get! However… Life is not so simple is it! If it were only HIV we had to worry about! Whilst you may be relatively risk free from HIV by having a chow down on some horny blokes kielbasa you are still at risk of infecting your throat with Gonorrhea, Chlamydia or Syphilis and whilst, certainly with the first 2, these may not necessarily be of much consequence to you in your mouth (Syphilis is nasty wherever you get it!), the next person you chow down on is gonna be at risk of being infected in his cock from you! A secondary problem with having a STI living in the back of your throat is that it can make you slightly more at risk of getting HIV from oral sex!

All 3 of these bacterial infections can be A-symptomatic so you can never know who has them. The only ways of getting round these problem are from the following options:

1.   Never have oral sex again! OMG, that’s a bit draconian!
2.   Only ever have Oral sex with a condom. Great if you like sucking on a dildo or love the taste of lube, spermicide and latex.
3.   Only have oral sex with a regular partner whom you are 100% certain you are monogamous with.
4.   Go get tested regularly for a full MOT at the GUM clinic

If you have oral sex with a different partner, a casual encounter, a one night stand, a quickie in the bushes, cottage or sauna, a nosh job in the night club toilets, a 3some with your boyfriend, whatever it is that you have done then really, you are at some risk of having picked up something. This goes the other way too. Just think what could have been at the back of the throat of the last guy you fed your cock to! The best way you can be responsible for your own sexual health, if like me you live in the real world and admit that you do have some kind of active sex life, is to get yourself down the clinic every 3-6 months and have a full screen. It doesn’t take too long and is hardly embarrassing, especially if you have no symptoms. You can smile to yourself that you are just performing some essential maintenance. I mean, would you leave your £15,000 new car for years without a service? Then why not treat your own body the same. 

So getting back to the health promotion. Being a health promotion outreach worker is so much more than just giving out a condom and a lecture on using a condom. It involves openness and empathy and getting a message of risk management and personal responsibility across to people who, as a rule, don't want to listen. It involves increasing awareness of sti's and std's by using humour and tact and wit, something most gay men have in abundence. I can't wait to get started! And for me, I would say it will involve showing that I am not separate from the community which I am reaching out to but that I am a functioning member of it.