In the age of Truvada, what did it mean to learn he had HIV?
A good deal of progressive rhetoric in the years of the AIDS epidemic was based on a guiding idea: that ignorance was an equal partner with the HIV virus in the deaths that occurred. But in the twenty-first century, where the virus is not only treatable for the HIV-positive but also more easily avoidable for the HIV-negative, what kind claims can we make?
In the first world, and at least among the insured, an HIV infection is readily treatable with anti-retroviral therapy. Gay men like me who are reasonably privileged and negative (in my case more by luck than by any consistent responsibility in my younger years) can take a PrEP pill daily and feel reasonably confident they won’t seroconvert. Aside from complaints about “Truvada whores” and the “only condoms are legitimate” refrain of plague survivors like Larry Kramer, the playing field is remarkably different now than it was even five years ago.
So what should — no, what can I make of the last relationship of my twenties? He was positive, and I was negative. My six months with “Chad” was not my first serodiscordant relationship, nor would it be my last. What shook me was the experience, six months after the relationship ended, of finding all of this out. That is to say, we had been having penetrative sex without condoms or Truvada, and I had no inkling of my boyfriend’s HIV status.
In the following months, I struggled with bitterness, with an inexhaustible tendency toward pettiness, and with my own mental health. It is an indisputable blessing that I remain negative. Becoming positive wouldn’t have been the end of the world, either, but the absence or presence of a virus in my bloodstream does little to undo much of the resulting damage to my sense of the gay community and my trust in others. That has taken concerted effort, and the growth has rarely been linear.
I had been friends with Chad for more than a year by the time we first landed in bed together. In the earliest days of writing my dissertation for a doctoral program, I had begun to indulge some of my more scattered impulses: toward procrastination, toward extroversion, toward drinking. Chad was several years older and had a well-paying job at a media company, but shared some of these frantic and escapist traits.
He also had a boyfriend, at least for the first nine months I knew him. In the earliest days I found both of them attractive, even. There was an appealing goofiness to his relationship with “Eric,” but also a childish volatility. As a consequence, meeting the two of them one November night at a friend’s felt both overwhelming and endearing. I couldn’t remember which one I found more attractive at first, but it was usually Eric who would act flirtatious toward me and Chad who would insist that their relationship was closed.
There were grim things to come for their relationship. While the following winter and spring sailed by, and my own bad habits flowered in the sticky world of San Francisco dive bars, I watched the two of them hit a few unnerving speed bumps.
One April day, I ran into Eric in the park. “Chad and I broke up,” he told me. I invited him over to watch an episode of Mad Men with another friend. Eric was grateful for the company but entirely unwilling to discuss the details, except that he’d returned Chad’s apartment key. The next thing I knew they were back together, and as Chad would have it, they had never broken up. “No,” he explained with a strange insistence, “We both just thought the other one thought that.”
The other friend who had been there that evening for Mad Men compared the claim to how that show’s flawed protagonist responds when his daughter sees him having an affair. “I know what you think you saw,” Don says to Sally. We in the audience cringe because he is at the same time hapless and invalidating. But even in my friend’s joking reference, there was a kernel of truth I wish I’d been able to sit with. But sitting with intuitions has never been my strong suit, and the defects of my own character — impatience, aggression, pride — led me to dismiss the sense that there was an inauthentic streak at play.
When Eric and Chad split for good that fall, my cohort of friends began to see much less of Eric and much more of Chad. When I was evicted from my apartment in Bernal Heights, a San Francisco neighborhood just south of the Mission District, Chad even suggested I might move into a bedroom in his two-bedroom, mid-century apartment at the foot of Twin Peaks. But then, he claimed, something went wrong: just before I agreed to move in, a friend of his from back in D.C. had texted in hopes of doing the same.
After I found a place of my own across the Bay in Oakland, he told me this friend was staying in D.C. after all. Another of our friends moved in instead. But then getting back to Oakland after a night in the City could be an exercise in patience, requiring a wait to cross the bridge on a bus crowded with other drunks.
And as it happened, I ended up alone with Chad on a night just a few months later. His roommate was out of town, and he invited me to share his bed. We embraced one another, shared a kiss, and Chad let me know how fortunate it was that we hadn’t become roommates. Something about it had the magic of an offbeat romantic movie or a sitcom. It was hard to imagine how things could unfold, or how devastatingly rough the breakup would be in the months before I found out the whole story.
Naturally, we both hesitated about dating for a time. Both of us were extroverts, and neither of us wanted to upset or divide our group of friends. But it seemed like there was an attraction and a warm tug that life was too short to ignore.
There were a few very happy months. He had certain things that my life as a graduate student had left me without, and I had a broader group of friends who seemed mostly to enjoy his company. Most of all, he seemed affectionate, engaging, and down for almost anything. A while had passed since my last serious relationship, and it felt in many ways that I’d escaped the endless insults to my ego posed by the single life.
I can’t say that the breakup began any different from other rejections. We both drank heavily, and drunkenness would bring out streaks that didn’t always harmonize: he would get impatient while I would get scattered or clumsy. When I dropped a to-go tub lamb curry, his reaction left a few of my friends unsettled in a way they long remembered.
Then there was a trip to Russian River, where Chad seemed alternately to open up and to withdraw in irritation. He told me he had brain cancer at one point, and had been heavily medicated with Benzodiazepines at one point in the past. He credited getting off them with him finding his lust for life again.
Then he would get irritable: I hadn’t run the GPS right, I hadn’t helped enough in the kitchen, I hadn’t lifted our canoe onto the hooks. Certainly, my own heavy drinking had not helped my concentration, but it was also clear that his urge toward a tight ship was playing into a feedback loop.
A week after the trip to the River, our closest shared friend hosted a fundraiser for the AIDS LifeCycle. Chad had donated a generous sum, and I had been joking about his refusal to give to any more of the countless ALC fundraisers in town. “Chad already blew his AIDS wad,” I said.
When I made this joke at the party, I got an uncomfortable stare from our host, which I didn’t understand. Within a few minutes, I found Chad’s aggression back in full force. Many drinks in, I was struggling to keep up as dealer of a card game. “This is just like Russian River!” Chad announced to everyone there. I grew livid, I shut down, and at some point in the night blacked out.
After another week of finding him implacable and seeing him start what, in retrospect, were fights designed to end the relationship, he asked me to meet at a bar. This was the Friday of San Francisco’s Gay Pride weekend. Still in remarkable denial about what was happening but with my mind on a dissertation chapter, I asked him if we could meet a few hours later than he suggested.
“When are you thinking?” Chad asked. He told me a co-worker at his media company and a friend would be joining us. Of course, they never came, and the breakup came like a sledgehammer to the carefree life I thought I was finally living.
The following months were a nadir. Over the course of that public weekend, I took every chance I had to lash out at Chad. Then, in a reversal of course, I made repeated attempts to understand why we had broken up and to find a way for the two of us to reconcile. I found him constantly dodging the questions and never showing up at the time he’d agreed to. Through all of this, I alienated my share of friends with my neurosis, my anger, and a strangely obsessive self-blame.
I had recognized, on an intuitive level, that there was something fundamentally dishonest in his character, but I also could not imagine what I did not factually know. In the moments I thought he was communicating most frankly, he pointed to our trip to Russian River as a turning point for him. Then he pointed out, jaw clenched and eyes fixed on mine, that I’d refused to submit to him sexually on more than one occasion.
In the grips of depression, a time when I began to come to grips with how my drinking had shaped the shape my life was taking, I believed almost everything I’d been told. I’d been a lazy drunk, an irrationally reluctant sex partner, and generally inconsiderate, hadn’t I?
It was back in the park, one day at the end of that summer, that I ran into Eric again. I’d seen nearly nothing of him the whole time that Chad and I were dating, and I learned he’d not even known that we were dating until it ended. He told me I wasn’t missing out on much in losing Chad, and expressed a desire to be on friendly terms. Then, as the year ended, the details began to fall into place.
I saw Eric’s new boyfriend at a coffee shop and told him I’d had a rough year. Eric texted me about meeting a few days later. We ended up talking at a gay bar in the Castro, where the city’s old streetcars turn around and head back downtown. The bar, Twin Peaks, is famous for being the first in the country to allow people on the street to look inside.
“Are your T-cells okay?” he asked me, staring away. As I made my way through soda water after soda water, he had a few more drinks and told me the whole story.
The past years of my life began to make more sense than they ever had. There was almost a narrative high to be gotten from finding all of it out, like life had suddenly taken on the contours of a detective film.
That fight that had broken them up temporarily that one spring day? It came after Eric had found Chad’s HIV medication. Chad had even claimed his medication was PrEP, until Eric pointed out that only Truvada would be prescribed as a preventative measure. Ultimately our common friend — the host of the ALC fundraiser — had intervened, in hopes of saving the relationship despite the betrayal of trust. All I ever heard from Chad is the claim Eric had forced him, embarrassingly, to go to couples therapy. At the same time, Chad had told that same friend that he’d turned over a new leaf and had been telling his sexual partners.
Pieces that seemed inexplicable now made perfect sense. I came to understand my friend’s glare at the fundraiser, as well as another glare he gave later that summer when I said that I’d dated “a positive guy.” In the matter of a few hours, all of this was confirmed by the same mutual friend, and I tested negative again. For the first time in my life, I intuitively grasped what it was to dodge a bullet.
But I hadn’t gotten out unscathed, had I? There were months of depression, there had been self-loathing and a deep confusion about my own competency and judgment. I was still negative, yes, but I had also been put through an emotional wringer the likes of which no one could easily understand without investing more time and empathy than most of us regularly possess.
For a time I took some comfort in trying to assign labels to Chad’s behavior. Narcissism. Sociopathy. It might be most compassionate to wonder if he showed the lying streak you would see in an active alcoholic, something I was certainly courting in the time of my own worsening habit. My thoughts turned again to TV’s Don Draper, a high functioning alcoholic who constructed a life based around a lie about his identity.
In time, I began to realize that the label for Chad’s behavior didn’t matter as much as my experience, which has been grueling in so many ways to narrate and explain. Our society has made great strides on the rights of LGBT people, and I can’t imagine it turning the same blind eye today that it did in the Reagan Era.
But what about the psychological toll that we pay when we arelied to about a vital and factual matter? A brand new, deadly wasting disease would make rightly make national headlines, but there are few national headlines about the lies that people, gay or straight, tell their partners, spouses, and families. But it seems, at least from my experience, that many of us have had comparable experiences in our lives that shatter our trust.
Usually, when Americans talk about integrity and honesty, the tone seems almost conservative, reminiscent of family values talk at a Republican convention. But would anyone doubt that it is those with preexisting vulnerabilities, those who are less privileged with respect to class, race, gender, sexual orientation or health who bear the greatest brunt of dishonesty and manipulation? Even in a place with the liberal voters of the Bay Area, it can be a daily heartbreak to watch these dynamics play out.
In trying to rebuild my life since those six months with Chad, I’ve found that my aggressive pursuit of the truth still requires tempering with humility and patience. But I’ve also come to believe that deception and manipulation are their own kind of epidemic, albeit one whose beginning is impossible to mark and whose breadth are impossible to quantify. One can address a drinking habit that isn’t helping things, one can take up meditation and consult a therapist, and one can invest in friends who are loyal and principled. But human society is a diverse ecosystem, and its nooks and crannies can hold both selfishness and deep fragility.
So what is the answer? It is possible, as I did for months, spend a good deal of time in the swamp of vindictiveness and anger. If dredging that swamp by simply writing is an illusory goal, surveying and describing it might at least give others a broader sense of how murky its borders can be. Not to seroconvert is not to avoid suffering, any more than seroconversion guarantees a life of loneliness and pain.
Indeed, if the miracles of medicine have changed the rules of the game, they have also changed the teams. There are HIV negative people who remain some combination of reckless and naive. There are HIV positive people who are either careless or deceitful. But, most importantly, there is a group I still hope contains the majority of us, who find a way to work at accepting all manner of difficult truths — about our lovers, about our companions, and about ourselves. Whatever the issues are, and whatever the shame or grief they trigger, I think we will find more balm in confronting them than in any pharmaceutical.