HIV and the End Times

Over 1.2 million Americans are HIV positive.

I met B when we were in college. He, like the rest of our classmates, came from a local, affluent white family and believed the world had wronged him whenever there was a line in the cafeteria. We had one thing in common, aside from our alma mater, and we desperately tried to bridge that gap between ICP and our other interests. We went to themed nights at bars and studied together, and on a long night, like you do when you’re millennials in college and making friends, showed each other our high school and childhood photos and blogs and hobbies. 

B’s parents sent him to boarding school, his grandparents paid for his private undergraduate education. I went to a public school featured in a charity tour by Bono and Ashley Judd and spent whole weeks applying for scholarships, took out loans in numbers I couldn’t visualize. He found the music as a rebellion. I found it because Juggalos are my people. 

On our way to lunch early in our relationship, I gave my only cash to a dirty teenager at a bus stop and B snatched the $3 from my outstretched hand. 

“She’s not really homeless,” he passed the money back to me, “look at her cell phone.” The teen was wide-eyed and unwashed and certainly not a college student on the way to eat pho. I handed the money back to her with an apologetic smile. 

“Why did you give her that she’s clearly faking it.” His voice pitched up with distress. “Why would anyone do that?” I asked, embarrassed and annoyed. 

“To sucker people like you out of your money. Believe me—I used to do it.” 

My gait faltered, “You used to fake being homeless?”

“Yeah, we’d ditch school and see how much we could get.” 

“Wow.” 

I couldn’t believe any of what I was hearing, couldn’t process it. My stomach pinched, twisted. I couldn’t handle B’s incredibly ugly beliefs, actions. 

“Can’t believe you gave her your money,” he scoff-laughed, acting like I was a special kind of fool. Like we didn’t live in the runaway capital of the country, a city with no middle class. And I was studying social work. 

Later, I would tell another friend about the experience. I’d ask how common that phenomenon could possible be. She said, “What I do with my money says something about me. What you do with it says something about you.” 

At 21 I was shy, impressionable, and drunk at least as often as I was in class. I was among the poorest students at my university and I seemed to be the only person who chose the school for its social justice focus. 

I didn’t have many friends and I was struggling in my classes. I thought B might understand. 

An estimated thirteen percent of people living with HIV are unaware of their status. 

After college I spent a few years working and living near school before moving to a college town in the middle of corn fields in the midwest. A few months after I moved, B came to visit. He was a fine guest—he did research on the town, took himself hiking and made dates on the apps. At breakfast one day he told me he would be moving here. He had become bored of landscaping, felt it was time to use his engineering degree and leave his hometown behind. 

We apartment shopped and bar hopped and after a few months and two surgeries (to get them out of the way before losing his mother’s insurance) he became my temporary roommate. It was an awful couple of months in which he declared that leaving the TV on at night made an unfair impact on the electric bill and he wouldn’t pay a third of the bill. After actually doing the math, he begrudgingly recanted, only to break my favorite mug and shrug about it. I swept it up. Since he didn’t want to share bills and I didn’t want to clean up after, it was a short-lived situation. He found a job and his own place relatively quickly and started working and dating more seriously. 

HIV is expected to take only three to five years off of a person’s lifespan. 

Since the turn of the century, outside of stigma and external factors, quality of life is not documented as changing for people post-diagnosis. 

Sometime in that last year, this very type-A gay man took himself for an STI test and asked for PrEP. Pre-exposure prophylactics had been on the market only a short while and B wanted it. Except, the clinic wouldn’t give it to him? 

Apparently, he wasn’t a high enough risk for contracting HIV. 

According to B’s reporting, this is because he had a vagina. He did not use his vagina for sex, though. He self-reported on his sexual activity. And he was denied the prophylactic. 

PrEP or Pre-exposure prophylactic is a regimen of pills taken to prevent acquiring HIV. It reduces the risk of acquiring HIV through sex by 99.9%. It became available to the public (via prescription) in 2012. Different versions of it can be taken either daily or only prior to anticipated contact. 

PEP or Post-exposure prophylactic is a heavy duty course of HIV medications taken as quickly as possible after exposure to HIV. It’s like Plan B. 

B: Don’t tell anyone 

B: I have HIV 

B: Can you come to my appointment Tuesday and take notes? 

B: All day 

I said yes. Obviously, I said yes. I didn’t ask any questions, just the time and location, where to meet. I said I’d be there: firm, level, stoic. I brought a notebook with perforated pages, packed a binder and three-hole punch, hugged him so tightly I worried it was too much but I wanted him to know I wasn’t afraid. 

The university where B received his diagnosis had strongly suggested he bring a friend who would be unemotional and would be able to retain information. People are often so emotional at the time of diagnosis that they fail to hear anything about the virus, their healthcare, or their prognosis. Some don’t have anyone they’re comfortable telling, some of the literature is in medical jargon. I don’t know what happens if you don’t bring a friend. 

HIV is scary because our cultural memory stopped with the epidemic, on the violence committed against us by our own government, on the incredible, impossible actions our community created to get attention, support, pity, anything. We, the general public, never learned about Ryan White, except maybe to learn that gay men can’t donate blood because a nice suburban white child contracted HIV from a blood transfusion. 

We weren’t taught that Ryan White’s parents rallied for the queer community, forced the government away from the GRID narrative and used their teenage son’s legacy to fund lifelong healthcare for every single person living with the virus in the US. 

His doctors were kind and normal, reading the room well and adapting to us. 

“Technically, currently you do have what we refer to as AIDS. Now, all that means is that your blood count is low. Most people are diagnosed when they’re sick, so that makes sense.” With medication, that white blood count rises and instead of AIDS, we call it HIV. Eventually HIV becomes undetectable—the viral load is so low that it cannot be detected even by testing—and when it is undetectable it is also untransmittable. 

Technically, when you reach U=U status, you don’t have to tell anyone. 

Technically, legally, sharing anyone’s positive status without their express consent is a crime. I had always heard that if you’re HIV positive and you don’t disclose it with the people you’re sleeping with you can be tried for manslaughter. I don’t know if that’s true. 

B cried off and on all day, his blonde hair glowing white against his pink forehead. Insensitive, I know, I kept thinking, How is this all good news?? Because it was. B, who was a bit of a train wreck, now had healthcare, a social worker, a doctor’s note for all occasions. He had a team of people dedicated to his well-being. I was taking unpaid time off to be at this appointment. I would take as much time off as he needed me to, but still. I didn’t have a team of professionals looking out for me. 

I knew better—I did. I chastised myself: B was looking down the double barrels of a sawed-off shotgun where one spelled death and the other spelled forever alone.

The Ryan White program was the country’s quiet backtracking from the horrible late 20th century policies. If you are HIV positive and become so ill as to be unable to work, Ryan White will pay your rent. 

B took two weeks off from work, told his mom, who called me crying—alternately thanking me for my friendship and scolding me for not protecting him and not telling her. 

She dropped a five-figure deposit into his bank account to clear her conscience. B reached U=U status practically overnight. He no longer identified as positive. Or as trans. (He told me one night on the phone when I asked for company at a trans support group, “I don’t identify as trans. I pass.”) 

In 2020 he got a boyfriend who believed himself impervious to the novel coronavirus club and took his toddling siblings to Walmart as entertainment when it was his turn to babysit. 

B thought he was a delight: charming and boyish, and didn’t I believe in magic, I should get this guy’s whimsy. I thought B had a compromised immune system. 

B couldn’t possibly imagine what I meant by that. 

But I had people I cared for, a history of lung issues, and a disinterested in unannounced guests. Still, B brought his boyfriend a few fifths of liquor over to my place and I became a child unable to say no to a challenge, drinking beyond my inclination, vomiting til my throat bled, til liquor burned my nose on its way out, I was hungover whole days with my memory in tact, spotlight focused in on two horrible features of my guests: they were bullies. And they were relentless. In my memory of the night, my kitchen was dark but a bright orb shown around them and they goaded and joked and challenged. A child’s insecurity awoke in me and after every shot I said, so plaintively, “I’m awfully tired. I think it’s time to say good night.” 

I started vomiting to the sounds of them fucking in my yard and heard them giggle drunk into the boyfriend’s car and drive away. 

GRID, or Gay Related Immune Disease, was what the world was calling the Human Immunodeficiency Virus before they bothered to study it. It allowed them not to worry. It only affected the undesirables.

Repeatedly I asked B not to come over in those early days of COVID. When his doctor refused him a note to get out of work for the duration of the pandemic and instead encouraged him to mask, he decided to flout any warnings about public health because it obviously wasn’t his problem. 

When his brother was diagnosed with Leukemia late that year B quarantined himself for two weeks with a few gallons of vodka and hopped on a plane to the coast. When he returned, he masked religiously—two masks, one with a filter—and he literally hissed at strangers at the supermarket who came within six feet of him, swore at the unmasked and anyone he suspected was feverish. It was whiplash, sure, but at least this time it was safe. At least this time I felt safe. 

Often, survivors of abuse respond to the unknown by exerting control over their environment, however they’re able. Some people will clean, some will diet, others may shop. Many of these coping mechanisms veil acts of self-harm or self-destructive behaviors. 

As children, B and his brother J had each chosen a different parent and grew up in different parts of the country. B moved to California to be with his brother when he underwent treatment for his leukemia. He got a dog and a wetsuit and spent his days surfing and getting to know his brother. A year into his time in California he flew me out to stay at an airbnb near his place. Upon arrival he scheduled me a COVID test to be sent to a lab and paid for overnight results. We ate en plein air at taco trucks and B scheduled us four hours together each midday and then dropped me off for the afternoon or evening. A dream, honestly, as an introvert with so little in common with my friend. 

I took half days at work and then played in a beach town. I met J, ate good food, counseled B that calling the cops on homeless people does not help anyone. There were a lot of unhoused people near his apartment. He didn’t like them near his dog. (Apparently these bona fide homeless, unlike the teens in Seattle—with their hunched backs and chronic dehydration were dangerous for B’s poodle to sniff.) 

We had fun in San Diego, though. B marveled aloud when I looked up how to say “thank you” for our meal at the Georgian restaurant (matloba), his tongue slipping tipsy from praising my courtesy to complimenting the server’s ass—the waiter politely ducked away—and I snuck B’s key’s into my bag. I suggested we tour the neighborhood a bit. There are lots of pride flags around here. 

While grief is a near-universal experience, many Western cultures have made both the experience of it and any conversation about it taboo. Other cultures have deeply ingrained, often spiritual traditions around death, which aim both to honor the lost and alleviate the pain of the bereaved. These practices tend to involve emotional expression and time passing. 

His brother died. Gradually and then suddenly the treatments quit working. His young widow, forced to deal with two abusive parents-in-law, called in reinforcements. In droves, the brother’s college friends, the soldiers under his command, his buddies from basic training, they built a human chain around the bereaved wife. B called me. 

I had, that day, returned from a road trip (a familial duty), and was moving to a new home. But death doesn’t wait. 

I bought a black dress on the way to the airport and stuffed it into my backpack with my work computer and wallet and I apologized to my cats. 

When I arrived, B proudly announced that he was not drunk but that after the grocery store he would be. And that I would be driving the rest of the night, the rest of the airport pick-ups. The grocery runs. We went to the grocer that I had a gift card for and I bought ingredients for a large family-style meal. I would be staying with college friends of the deceased. As the only person here not actively grieving, I was happy to have a duty. I could feed people. 

When I woke up the next day, funeral day, B was on the couch, his back supine but with his head up and his feet on the ground, cradling a tall can of a name brand IPA. “Mibruvversdead.” I found the car keys first, put them in my tiny, funeral-appropriate clutch. Filled a glass of water and brought it to him. Flicked his shoulder and, like a mother, so softly it strained my throat, I said “Drink.” B nodded, the beer can slipping from his elbow. 

I left one beer in the fridge, moved the rest of them to the hope chest in the closet of the room I’d slept in. One of the college friends greeted me, asked if I needed to throw anything in the dryer for wrinkles. He was as big as the doorway, color of a shadow, couldn’t stop smiling, but his eyes were syrupy, red, curved down. I said no, headed for the shower. 

Wet hair a mess in my new black dress, I caught B stumbling lazily in his gunmetal gray suit. When B came out as trans, J did some research and made an appointment for a couple years down the line—when the internet agreed it would be safe to assume B’s frame was finished filling out—to get B measured for a suit. 

When B saw me his face lit up, and then, “My brother made me buy this suit because real men need suits. And now my brother is dead.” 

I was sturdy, stalwart. On the job. I straightened his collar, looped my hand through his elbow, steered him back toward the couch. 

He held still, twisted toward the fridge. Two of the college friends came into the living area. “We can drink after the service. Don’t want to be sloppy during. Don’t want to say anything funny,” I said making eye contact with the shorter, white friend. 

“Oh, yeah, good point. Shit,” the friend said, nodded at me. 

In an effort to understand addiction, there were repeated lab experiments in which rats were offered water bottles full of morphine. In the late 70s, some Canadian scientists added a variable. They kept their caged, sad, kibble-eating rats. And they created a habitat for the rats that included a variety of foods, mates, toys, and general autonomy. Both were taught to consume (sweetened) liquid morphine. Then they were given the option of morphine or water. The happy rats did not return to the drugged bottle.

That night, the next day, the next night, the next two, B was intermittently conscious, constantly debauched, I fed him Pedialyte popsicles and hide in my room, spent and raw. His sobs screamed, so drunk his eyes shook in their sockets and I’m somewhere else, someone else is drunk and I hide in my room, make myself small. 

B screamed lyrics to Disney cartoons, watched childhood favorites and raged into the rental’s couch. I shook. 

I took a ride-share to the airport. 

A month later he arrives at my house at dusk, lets his dog out to shit in my drive, and falls down drunk in my doorway like it’s the end of the world. And maybe it is.