Concerned About a Poz Buddy

[fskn]

I live in the San Francisco Bay Area and became aware years ago of the top-notch HIV prevention and HIV treatment services available in San Francisco proper. I also like to read medical studies and understand the science behind diseases and drugs.

Sadly, just across the Bay from San Francisco, neither private doctors nor the fragmented public health "system" (consisting of clinics for the indigent and contracts with Planned Parenthood, mostly for middle-class straight teen couples afraid of pregnancy) have sufficient experience or current knowledge in the field of HIV.

This side of the Bay, I watched a friend who had seroconverted wait many months to start ARV therapy. Research has clearly demonstrated the benefits of early treatment. As often as I could without damaging our friendship, I begged and pleaded with him to visit San Francisco City Clinic. A year later, his private East Bay doctor finally put him on meds.

Similarly, I watched a 23-year-old friend seroconvert this spring, after I'd told him last summer about PrEP. He would have had to go to San Francisco to get it conveniently. (Even Kaiser Permanente, which operates a well-organized PrEP program in its San Francisco medical office, employs suburban doctors who don't know about PrEP and can't be bothered to look it up on the internal computer system, make a phone call, or condescend to a Google search. Such was my ex's experience at Kaiser Oakland last summer.)

Though I'm not responsible for what happened to either friend, I feel responsible. Could I have exerted more influence, given that I knew, medically-speaking, what to do and where to go? Lack of knowledge, coupled with an accident of geography, has damaged my friends' health. I've decided to be more vocal with people I care about, from now on.

You are doing the right thing by bringing up HIV treatment with your friend. Be persistent. It's a sad to contemplate, but his getting frustrated with your advice might end the friendship, which might in turn serve as a wake-up call, bringing him one step closer to seeing a doctor.

[Guest GoodExercise]

We all make our own choices. He isn't telling you what to do -- and you wouldn't do it, anyway. Why should he do what you tell him to do? Oh, because you are right and he is wrong (even though it is his life)?

[seaguy]

If you were not concerned then you would not be a very good friend to him. But to stand by and do nothing while he goes without seeing a doctor is like watching a slow motion train wreck or something you want to do what you can to prevent it because that is a natural human response for most of us.

It's sad that he is so uneducated about HIV and treatments I think if he were to get a little more education in that area it could sway him? Do you get a sense that it would Poptronic?

[VersatileBreeder]

We all make our own choices. He isn't telling you what to do -- and you wouldn't do it, anyway. Why should he do what you tell him to do? Oh, because you are right and he is wrong (even though it is his life)?

GoodExercise, I'm not trying to tell him what to do, I'm trying to educate him so that he sees what path he is headed down. I see him as someone who needs help, not just with his health but also mentally. He is delusional about HIV and what it will do to him.

If he was able to look me in the eyes and say, "yes, I know I have HIV. I know what it is and what it can do to he body if left untreated. And I am okay with that. I don't want to go on meds. I am prepared for the consequences and death that will follow," I wouldn't be concerned about him. But that is not the case. He is scared. Scared to the point that he doesn't want to talk about or think about it as a mechanism of dealing with his fear. He doesn't realize that what he is doing to play down his fears now is what is ultimately going to destroy him in the end.

[slowfuck]

He is scared. Scared to the point that he doesn't want to talk about or think about it as a mechanism of dealing with his fear. He doesn't realize that what he is doing to play down his fears now is what is ultimately going to destroy him in the end.

That seem to be a common reaction, and similar to people deep in debt with unopened letters from the banks piling up, only making it worse. Much as it hurts, they won't listen though, until they reach a crisis point and have to face it. Not a happy situation to watch. I generally feel that people will not do things you tell them to, so that won't work. However, the idea of keeping the dialogue up but in general terms and not putting him on the spot, is probably the only thing that you can do. Discuss the problem impersonally, in other words, but occasionally or you will likely lose his attention.

Edited August 8, 2014 by slowfuck
spelling correction

[VersatileBreeder]

If you were not concerned then you would not be a very good friend to him. But to stand by and do nothing while he goes without seeing a doctor is like watching a slow motion train wreck or something you want to do what you can to prevent it because that is a natural human response for most of us.

It's sad that he is so uneducated about HIV and treatments I think if he were to get a little more education in that area it could sway him? Do you get a sense that it would Poptronic?

seaguy, to be honest, I really don't know if educating him is going to help him at this point. I am hoping it will, but I am not sure if he's made up his mind for good on this one.

The other night we talked about this for about 40 minutes. I told him literally everything I know about HIV- what it is, how it progresses, how meds suppress it, why it's not the big bad scary monster of a disease it once was anymore, etc. I also gave him my experience with it- how it scared the ever living shit out of me when I found out I had it and how I progressed to not being scared of it because of my being proactive about it.

Some points I made seemed to resonate with him, but most of what I said seemed to just bounce off him like he didn't want to hear it. The conversation I had with him felt a lot like the convo I had with a friend a couple years ago who started getting into meth. When I saw the downward spiral he was on, I tried to help him, but he didn't want to hear it, just kept telling me that he wasn't going to get addicted to it. Now he's homeless in Brooklyn, and I get calls from him time to time asking for money or a ride to get somewhere. I just tell him that I told him this would happen and I will not enable him. Then he tells me I'm a bad friend. Whatever.

I guess we can only try to help people so much right?

[GermanFucker]

Sounds like he's a long-term non-progressor. He may be better off not taking meds, but he should be monitored since even long-term non-progressors do, usually, progress at some point. Another possibility is that he's not, genetically, a long-term non-progressor, but may have a really mild strain of HIV that doesn't progress very fast (or ever).

The trick is finding a doctor who would be comfortable with him not being on meds.

Realistically after 12 years, he's probably pretty sick. Although some peoples decline is longer than others. Even at the height of the crisis, there were people that were likely infected in the late 70's who didn't get sick until the late 80's or 90's, which is actually when AIDS deaths peaked. That means a 10-15 year incubation timeframe.

AFAIK the average time from infection to AIDS is around 9 years, so 12-13 years are on the longish side, but not extraordinarily so. Even if it takes 17 or 20 years, that doesn't necessarily make on a long term non-progressor. For that your immune system has to supress viral replication to a point were the viral load stays constantly low and doesn't rise. But one only know that if the VL is check regularly.

He might be LTNP (less likely) a slow progressor (far more likely) or he might already have one foot over the abyss and his immune system will soon collapse (lets hope not).

A personal thought your friend might find helpful:

One of the greatest qualities in humans is our almost limitless potential to adapt to basically anything. Of course it takes a bit of time to come to terms with the changed situation, but soon we accept the new normal. It will be a different normal, but it will feel just as natural.

[cam1972]

We all make our own choices. He isn't telling you what to do -- and you wouldn't do it, anyway. Why should he do what you tell him to do? Oh, because you are right and he is wrong (even though it is his life)?

Wow..... So.... He's not supposed to give a damn? Yes. It's his friend's life. But it's called CARING about a friend's well fare... This isn't about who is right and who is wrong. And just because it is his life does not mean the choices he is making are right. I've had times in my life where I needed guidance and direction. The friend in this situation is lucky to have someone like the OP who is trying to give him that very thing.

[VersatileBreeder]

Wow..... So.... He's not supposed to give a damn? Yes. It's his friend's life. But it's called CARING about a friend's well fare... This isn't about who is right and who is wrong. And just because it is his life does not mean the choices he is making are right. I've had times in my life where I needed guidance and direction. The friend in this situation is lucky to have someone like the OP who is trying to give him that very thing.

Thank you Cam. You stated my point even better than I did.

Anyone who thinks "it's his life," should put this in perspective... Suppose you were walking across a bridge one day and saw a friend who has been through hard times standing in the middle of it, ready to jump off. Would you just say, "it's his life. If he wants to jump, let him jump."? Or would you try to talk him off?

I know this scenario is a bit extreme compared to the one I am dealing with now, but if you think about it, they're not all that different. The only difference is one is ready to kill himself immediately and the other is letting himself die very slowly.

We all have people in this world that we care about, among them are our friends. When we see their lives in a crisis state, it's natural to want to help them, even if they don't realize they are in a crisis.

Great example is a good friend of mine, a girl, who is trying to help her best friend. Her best friend is in a very bad relationship with an emotionally abusive and controlling guy who has already sent her life into a downward spiral in so many ways. This girl doesn't see it because she is convinced she is in love with the guy.

Likewise, I am trying to help my friend who lacks the education, as well, has become disillusioned with a very real problem that he has.

[Guest BBBoyfromTN]

Your buddy sounds a lot like me. I tested poz twice on an Oraquick but just don't want to deal with seeing a doctor, the meds, all the tests, the costs and all, and honestly I feel fine, think I look fine, no problems at all. I just dont care. Maybe if I get sick and shit I'll go on meds. 

[Guest BBBoyfromTN]

I can relate to your buddy. I did an Oraquick last year and it came up poz. Tested again and same result. I was, and I guess still am, paralyzed with fear.im scared of going on meds, scared of what it will do to me. I know it's gonna fundamentally change my life. Aside from new friends I don't have a huge support network or much family. I haven't told my mom. I haven't gone to support groups but probably should. I feel absolutely fine too. I'd never heard of non-progressors and so maybe that's what I am? I guess I've compartmentalized it. I know I'm probably a horrible person for not getting tested and on meds but I just want to live my life and have fun without this hanging over my head. I know that the situation will probably change and will deal with that when the time comes. 

[lower_bucks_bottom]

@BBBoyfromTN The meds now a days, for most people, are just a single pill a day with no side effects. If you start taking them as soon as you know there is no reason to not live a long normal life. It is when you wait until you start feeling sick that you have done damage to your immune system and can have problems even after you start. I know that I felt fine when I was tested, but I found out that I had a viral load of 186,000 and a CD4 count of 365. If I had waited longer I would have been in real trouble. Now I take 1 pill, am undetectable,  have a CD4 count of 1000 and still feel fine. I also know I can fuck bare without infecting someone and I can take as many loads as I want.

Get tested and get on meds and  enjoy life

[PlayfulPup]

@BBBoyFromTN -- I delayed going on meds for 4 years after seroconverting.  Partly out of fear about side effects, but mostly because I didn't have health insurance and didn't qualify for assistance.  Those years took a serious toll on my health & immune system.  The symptoms and secondary infections got pretty bad.  I was miserable.

I finally found a way to get on meds and my well being rapidly improved.  The side effects were mild -- fun trippy dreams for the first week, then grogginess in the morning after that.  I've switched meds twice; last two have had NO side effects.  Most of the meds are once-a-day -- not much different than taking a vitamin.

Although my immune system improved, it never fully recovered.  It takes me longer to heal from bruises and cuts; longer to get over colds, flus, and sinus infections.

I'd spare you that suffering if I could.  Please consider getting CD4/CD8 counts and starting meds.

[1nOnlyCumDump4All]

Study shows the virus works in all walks of life differently funny there are people that never pop a pill but some how to have a view load extremely low and T cells at the normal level for years I only say this cause someone close to me had it since I was 7 and they still alive and loving life did nothing the doctors told them to do and my uncle may he sip did everything they said and at the rate it was killing men back then took his life after 10 yrs the person I speak is my mother she is still here and I’m up in age not to far up but 40 yrs and my mother is still on this earth 

[str8mature5]

I'd say you had your disscussion, maybe mention it once in awhile after you visit a doc, but don't push it you might lose a friend, Your intentions are good but it's up to him.