I'm a 28-year-old gay man. I recently learned that my longtime boyfriend seroconverted. Since we used condoms for intercourse only about half the time, and I was the bottom, there's a pretty good chance I'm positive as well. But here's my problem. I can't face the HIV test. I've just never believed that I could be positive one day, although my behavior would indicate otherwise. I've always been the "good kid" and there's just no room in my identity for the diagnoses. I know I have to get the test, and that HIV is entirely treatable these days, but I harbor so much self-hatred about letting my guard down and denial about taking the next step to take care of myself. I dread disappointing my friends and family, who expect so much of me.
He Said: Wow, you are laying quite a burden on yourself. It's great to be raised as the golden child, but it sounds like you are taking that distinction a little too literally. And gay men often feel an extra pull to perfection, as much of the culture is condemnatory. Part of growing up with such high expectations is that you can become a something of an island, and asking for help can feel darn near impossible.
You did let your guard down, temporarily, but that's a perfectly human mistake. You have to forgive yourself. There is probably not a young adult on earth who has not made a similar mistake. Don't assume your HIV status quite yet. Some people resist HIV through multiple exposures; some seroconvert after a single unprotected episode. But none of that matters now. You need to start reaching out and asking for support.
Talk to your BF to see how he managed the test and the news of his seroconversion. He's most likely been through a similar process himself. Talk to your physician. No one is going to force you to take the test before you are emotionally prepared, but the doctor will certainly remind you that the earlier HIV is treated, the more likely the drugs will keep it in check for the rest of your life (which should be totally normal, by the way). If you are positive, you will likely be undetectable for a long time. Long enough, in fact, since you are so young, that there's a good chance HIV will be cured by the time you reach middle age.
Take your best friends out to coffee and explain your stress and your fears (no need to concern your parents just yet). Make sure that your health care is in good standing, or sign up for Healthy SF, the brilliant program for SF's uninsured. If you are poz, your meds will be covered, free of charge. Finally, SF is blessed with some great HIV/AIDS advocacy, testing, and counseling groups. You can sign up for an appointment online at Magnet, the wonderful Castro clinic that could not be more supportive and gay friendly. Plus, the guys who work there are cute and nice. And, yes, many of them are poz. Good luck.
She Said: Two years ago, researchers at the Center for Sexual Health Promotion at Indiana State University carried out the largest study on American sexual behavior in the past two decades, involving nearly 6,000 people. In it, they found that less than half the adults polled used a condom the last time they had casual sex. This isn't to say the condom rule isn't a wise one; we all know it is. But look around and talk to your friends; you're not the only one who's slipped up. Of the many friends I've discussed this topic with over the years—gay and straight, male and female—I can't think of one whose condom behavior has been perfect. So, bottom line: You're human.
You need to really focus here on what a different disease HIV is today than it was 20 years ago before the advent of HAART (highly active antiretroviral therapy). Indeed, if HIV still killed most of its carriers, you and you friend would have probably used condoms much more religiously. But the fact is, if you do have HIV, it will in essence be a chronic, not fatal, disease. According to a study published in the AIDS journal this past January, a 30-year-old who contracts the virus can expect to live to 75 as opposed to the normal life expectancy of 82.
I say all this to assure you that if you have HIV, you will be okay, and to urge you to take the test as soon as your doctor suggests and get it over with. At this point, denial helps nothing and the test is a win-win. If you're not positive, you can rest easy (and go buy a big box of Trojans); if you are, you can begin to educate yourself and get support. The “golden child" syndrome is just that—part of childhood. All "perfect" children fall from grace at some point in adulthood, be it from illness, failure, divorce, addiction, loss of a loved one, or just the good old wearing down of one's youthful, usually sky-high dreams. No man is an island and no man is perfect. Luckily we're all in the same boat. Dare to admit your vulnerability and humanity and you'll find out just how loved you are.
Confused? Curious? Heartbroken? Send you questions to firstname.lastname@example.org