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Went to the doctor for an annual physical and all I got was a positive HIV result


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You never really know how you feel about it until it becomes a reality. Yes, it will take some time to adjust, but you will.

I recommend learning as much as you can about HIV, if you don't already have a thorough knowledge of it, as its important to come to terms with it and you, as the two of you now will need to live together for a very long time.

I recommend reading the three guides from project inform for newly diagnosed people. You can read them online in PDF format, or can order a print version:

http://www.projectinform.org/hivhealth/

I think that is really great that you have told regular partners who you know. This is certainly important if you have topped some of them, though even those who top you may be interested in knowing, even though a lower risk to them. As you can see, there is always a wealth of advise and people to talk with here.

again, to reiterate, you'll be fine.

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Went for my first chat with the ID specialist yesterday. Wasn't quite what I expected... Had hoped the doctor would be able to tell me right away what my cd4 and vital load was. However that was not the case. They want to do all the drug resistance tests at the same time. So now another waiting game begins... It will be at least six weeks before I find all this out. I did get a short primer on which drugs are available and how they are prescribed, though to be perfectly honest it kinda went over my head. I'm hoping I don't have to take the three separate pills everyday. But I guess we'll see.

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  • 1 month later...

Update:

Saw the ID doc today and received some pleasantly surprising news: my load count is only 7070/mL and my CD4 count (731/uL) is basically in the middle of the normal range. Additionally, my virus is not resistant to any of the current class of drugs.

The doc, who says she is normally a proponent of aggressive therapy, said because my numbers are good, I have the option of starting meds now or waiting.

At this point I've decided to wait at least until my next 3 month blood work visit to decide.

Pros, cons, advice is accepted and greatly appreciated.

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Waiting is old school thinking. I'd be very concerned about an ID specialist who thinks this way. The new research shows that meds can wipe the virus out of the body if started before it gets into the latent CD4 cells where it hides. That process takes 6-12 months. Why would you want to wait? My first two "Specialists" said that I had to wait until my CD4 cells dropped to below 500. That is why I saw a third doctor. What other disease do you know of where protocol is to wait until it damages you enough before beginning treatment? Back in the old days when the meds were almost has harmful as the virus, waiting made sense. Now, the dosages are lower and meds less toxic. There is NO advantage to waiting. Unless you know it has been over six months since you were infected, why would you give up the possibility of eradicating the virus before it completely invades your body? This point is another reason why testing regularly is so important. That way you can narrow down the window of the infection. I really think you need to see another doctor.

Also, the six week wait for test results from blood work is inaccurate. Your doctor will have the results within a week of you going to the lab. You might not be able to get another appointment until six weeks later, but none of the tests take that long. Your doctor scares me.

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Update:

Saw the ID doc today and received some pleasantly surprising news: my load count is only 7070/mL and my CD4 count (731/uL) is basically in the middle of the normal range. Additionally, my virus is not resistant to any of the current class of drugs.

The doc, who says she is normally a proponent of aggressive therapy, said because my numbers are good, I have the option of starting meds now or waiting.

At this point I've decided to wait at least until my next 3 month blood work visit to decide.

Pros, cons, advice is accepted and greatly appreciated.

Dont wait. The newer therapies have been shown to be very well tolerated by most people, and have almost none of the side effects of older therapies. Additionally it has been show that HIV starts damaging the body immediately after infection, and really any amount of time with unchecked HIV infection can be dangerous for your health down the road. Also HIV "reservoirs" in parts of the body that are difficult for medication to reach build up after initial infection, current research suggest the faster the treatment the less viral reservoirs there are.

Also as a person not on treatment you are more likely to transmit the virus. Even if you bottom the rectum and intestines are an area of high viral activity mean there is more of a chance of transmitting it to a top.

Go on treatment there is almost no downside, and there are multiple programs to help with the cost of medication.

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Waiting is old school thinking. I'd be very concerned about an ID specialist who thinks this way. The new research shows that meds can wipe the virus out of the body if started before it gets into the latent CD4 cells where it hides. That process takes 6-12 months. Why would you want to wait? My first two "Specialists" said that I had to wait until my CD4 cells dropped to below 500. That is why I saw a third doctor. What other disease do you know of where protocol is to wait until it damages you enough before beginning treatment? Back in the old days when the meds were almost has harmful as the virus, waiting made sense. Now, the dosages are lower and meds less toxic. There is NO advantage to waiting. Unless you know it has been over six months since you were infected, why would you give up the possibility of eradicating the virus before it completely invades your body? This point is another reason why testing regularly is so important. That way you can narrow down the window of the infection. I really think you need to see another doctor.

ding ding ding.

All of this is great info. IMO some doctors like to give the option because some people really dont like medication, and IMO like tigers, they are doing their patients a huge disservice. Hard and fast is the way to go.

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Thanks guys I appreciate the feedback. Again it was an option she offered with the stipulation that if I changed my mind at any time I could call and get a prescription.

I'm pretty sure I was infected sometime between July and September. I got really sick with flu-like symptoms in late September that I'm pretty sure was my conversion. So I suppose it's been 6-8 months

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Thanks guys I appreciate the feedback. Again it was an option she offered with the stipulation that if I changed my mind at any time I could call and get a prescription.

I'm pretty sure I was infected sometime between July and September. I got really sick with flu-like symptoms in late September that I'm pretty sure was my conversion. So I suppose it's been 6-8 months

Yeah I would go on the meds. IMO 6 months is plenty long to wait. Your numbers are good, but the goal is to get them the best you can, Treatment will do that. Another good reason is that once you are infected and not on treatment, it is MUCH harder for your body to fight off any infection. So say you catch the flu, without treatment your cd4 count could drop 100 points, and your viral load could drastically increase. Yes, that is somewhat temporary, but you probably wouldn't get back to your prior high numbers.

Call in the script!

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(Accidentally hit post and editing period timed out while typing the rest)

... since infection date.

As for the time frame between the first visit and today's visit it was about 4 weeks - owing to the scheduling system employed by the physicians group/network I go to. However they have an online system where they post all blood work results and I was able to see them about 2 weeks ago. I knew my cd4 count was good because they posted the standard range, however I want sure how to read my load count so wasn't sure about it until today.

As for medications I'm not averse to taking them. I'm on daily depression and statin medication already so it would just be another pill.

Again thanks so much for the feedback it is greatly appreciated!

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You are right, it's just another pill. There are three now that are one pill a day regiemes and all have excellent reviews. Complera is the one I take and I have had no side effects other than fatigue, but compared to how I felt before the meds, it is minor. The advantage of the other two options is that Complera has to be taken with food. It's not a big deal, you just have to remember. And it's not that it upsets your stomach or anything like that. The meds are metabolized with food so if you take it without your body doesn't get the medication. When I first went on meds my doctor put me on Issentriss also. It is an older medication that is known for knocking the viral load down to zero very quickly. I was undetectable from 77k in 30 days. I decided to stay on it for five more months and it was too much. I was sick all the time. I've remained undetectable for 15 months on just the one Complera a day. It works. And it feels good to know that I am actually a safer fuck than the negative bottom who "thinks" he's clean. If you are at 6-8 months you should move quickly. Read the article Wood posted. The fact that you are highly infectious right now is another reason to get on meds immediately. Regardless of the gift giving fantasy crap, you really don't want to pass this to anyone else do you?

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I agree with those above. I think it's particularly important to start meds if you plan to continue barebacking. I cooled it until I got my viral load down, primarily because I wanted to know my meds were working before I continued to take unmedicated loads. Besides, if you infect someone and you know you're toxic, there are the legal and moral aspects to consider. If you're having anonymous unprotected sex with a high VL, maybe it's easier for you to say the other person should have taken responsibility for his health. But if you know you're toxic, and the person is someone who could trace it back to you, your life could get complicated really fast. I told my regular fuck buddies when I converted. All three initially dropped me, but get this, two eventually returned and started breeding me again when I became undetectable. My one MAJOR regret is that one of my occasional buds from out of town bred me when I was not undetectable. I couldn't bring myself to tell him. I have since lost contact with him. The fact that I could have infected him haunts me to this day.

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If you are correct that your viral load is 7,070 is not very high at all. Yes, you can still pass it on, but you are not "Highly Infections." Typical chronic infection viral loads are in the 60,000 to 120,000 range. At primary infection back when you had the fuck flu, you probably had a viral load in the millions, maybe 10's of millions. So if y0u've settled down to a natural set point of 7,070 that's great news. Generally doctors don't think it can be transmitted with a viral load below 1,500. You are not hugely above that

You're CD4 count is excellent -- normal for someone without HIV, when under stress. You don't have to worry about some cold or flu wiping you out right now.

Sooner is better with starting the antiretrovirals, but there isn't a great panic to start them immediately. It doesn't sound like you have impediments to starting the drugs, like insurance or finances, so you can start them at any time.

Start them when the time is right for YOU. You have to be mentally ready. If you are already, then start them.

You are making a lifelong commitment. In some ways I liken it to buying a puppy. Not a decision to be made lightly, or on the spur of the moment. Something to be carefully considered.

With a puppy, you're committing to adding stuff to your day, every day, regardless if you feel like it or not. Stuff like daily walks, and making sure he's got food in his dish. There will be some problems at the beginning too. The first few night there's a whining, yowling, whimpering little furry bud. There are some puddles and accidents, and maybe even an occasional upset tummy with an upchuck on the carpet. You take it all in stride, and the early stuff settles down. Eventually it's all just a daily part of your life. Throw in those occasional vet visits, and regular shots. But in the end, your furry pal becomes part of you, and a regular piece of your day.

With HIV, you have to be ready to take the pills. From the outside it sounds easy, but there are days it feels like a burden. For some people taking the pills is a daily reminder that you're Poz, and a daily reminder to beat yourself up about it. That's a mental hurdle few consider in advance.

You may need to find a method that reminds you to take them every day. Something that's right for you. A daily alarm on your watch, a phone app, those seven day pill cases, check mark on a calendar - whatever works for you. There's two sides to that. One is the reminder. The other is that, after it becomes really routine, you may have sudden moments when you can't remember IF you took the drugs or not. It helps to have something you can look at that says, Yes I did, or No I didn't.

If they need to be taken with food, the kitchen is a good spot to keep the meds. By the same token, the prescription bottle out on the counter, might be a great reminder for you, but you don't necessarily want anyone who walks into your kitchen to know that very private piece of your business. In the cupboard beside your coffee mug or plates might be more discreet, but still in your face enough. And maybe when you've got company - as part of cleaning up the house, consider moving them.

Modern drugs are MUCH better tolerated than the crap I started on. But it can't hurt to be prepared. In the beginning, many people get an upset stomach or the runs. Or it may just be a change in consistency of your poop. Pasty sausage press isn't unusual. Have an extra pack to two of toilet paper on hand, above and beyond what you'd normally have in the house. Have some anti-diarrhea meds in the medicine chest. The Costco sized generic 90 pills for under $10 is the best price I've found. The Walmart house brand is the next cheapest. And you may need to play with how much you take, and when to take it, until your stool returns to normal. After years on drugs, I still have to take it every day to change a smeary paste, into well formed nuggets that don't leave me feeling in need o a bidet.

Sometimes food, or sips of gingerale, Coke or Pepsi settle an upset tummy. Can't hurt to have on hand, a bottle of Pepto/Divol/Malox or whatever other liquid product works well for you.

If you do start to have some gut troubles, try to figure out if there are some foods that just aren't playing well with the meds.

You'll get the "take it the same time every day" lecture. That's mostly about making it a habit. I'm not saying ignore it, but don't let it rule your life. You can still sleep in on the weekends. The meds don't disappear out of your system at exactly 24 hrs. There's wiggle room there. Take em every day at the point that's convenient on that particular day. (If you look at the PrEP trial data, they could tell from blood tests if someone had taken the drugs 3+ times a week -- it doesn't go Poof in 24 hrs)

You will miss a few doses. It happens. We're human. Don't trash yourself about it. It's not a crisis. Missing too many is bad. But if there's a slip-up, and you remember later take it later, do it. Discover that you skipped a dose, and well - you skipped a dose. Don't stress. 95% compliance is what they aim for. Personally I miss about one a month, and my VL has stayed undetectable. It's always on the days when your schedule is wacky or different. The special holidays like Christmas and Thanksgiving, or getting up early for something special and rushed (like a trip to the airport) are common culprits. Pay attention to those.

Green said that you were secretly chasing. People are ALWAYS going to have an opinion on how or why you caught it. Ignore them. They'll eat at you. It happened - period. No used playing it over and over, with should-a, could-a, would-a done things different.

My experience with people who say "Neg Only" is that they didn't know much about HIV. Usually they have no idea about the Window Period. They have a false perception that HIV is spread by the guys who know they are Poz and under treatment. Maybe you were one of those. Almost all new infections are from "Clean U B 2" and "D & D Free" guys.

Reach out to Mr. "I can't cum" again. Maybe just ask if he's been tested since you played, cuz you just want to make sure he's OK. I'd bet he still has pre-cum. A good hard fuck, and micro-tears in his dick (with no blood) would be enough. If he continues to be an ass - then he is one.

With your low VL, when you get under treatment, you will become undetectable very quickly. When you're undetectable, there is almost no chance you can transmit the virus. Take a look at the preliminary results from the "Partner" study. 16,400 gay sex acts, and 28,000 straight ones over two years, and none of the neg partners became Poz from their spouse. Read this stuff and watch the presentation. Good for your moral, great hope for the future, and great info to hit the Pozeaphobes up the side of the head with.

I hate to say it, but prepare yourself for a lifetime of stigma and prejudice. It's worth looking at the graphics on The Stigma Project. Share them via social media if you're that type. Hell, I'm using them as avatars on some hook-up sites.

It just drives me nuts how people respond to us. For some reason the first thought that enters the mind for a large portion of Neggies is "You're mad as hell at the world for getting HIV, and you're trying to get even by infecting as many people as possible." I always wonder about those guys. Is that what they'd do if they got it? They thought of it first. Remind me again, which one of us is supposed to be the sociopath?

Most conversations where you reveal your status will go like this

. Ignore them, and move on. There are Poz friendly people out there. Treat them like gold when you find one.

I now start disclosing status conversations like this. "After years of study I've determined that there are only two reasons I have this conversation. You may think there are more, but really it all boils down to these two. I am showing my respect for you, and hoping to earn yours in return."

I've got a post at the end of this thread It's worth a read, just for some of the things to think about when responding to docs, and other medical staff. It's also got the internal struggle I go through each time I have to reveal my status.

There appears to be a great group of guys on here, with a ton on knowledge. Reach out to them when you have a question, or are having one of those "fear of Monsters under the bed" moments.

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Thank you for your well thought out response. I feel mentally prepared to start treatment and have already been thinking of ways to ensure that I take the pill every day, including getting a daily pill box.

I initially hesitated about starting treatment to see if I was perhaps a "long term non progresser." But after reading the responses by Tiger and others, I realized I would rather be able to continue my sex life with less guilt and fear of infecting someone else.

To defend green, I'm actually the person who originally brought up the subconscious chasing aspects of my sex encounters. The more I think about it the more I believe it's true. For the last two years (at least) I rarely asked about status when meeting someone from craigslist (where most of my encounters originated), but when confronted with someone's honesty I wouldn't follow through with the encounter.

That's why it wasn't as big of a surprise when my GP informed me I had tested POZ.

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