Living With and Learning From Disease: HIV

In the early '90s, I lived in the capital of gay America — San Francisco’s Castro neighborhood. Back then the area felt haunted. Cadaverous men, breathing from oxygen masks and leaning on canes filled the streets. The diners on Castro Street offered 10 percent discounts to PWAs (Persons with AIDS). At the cafes, people spoke of recently deceased partners and dwindling T-cell counts.

In the early '90s, testing positive for HIV was, for a majority of men, a death sentence.

I moved out of the neighborhood and returned some 10 years later to find the atmosphere of despair considerably lifted. My HIV-positive friend Daniel — an avid tennis player who looks perpetually fit — is a prime example of how much the outlook for someone with HIV has changed.

The credit goes largely to a class of medication called protease inhibitors, introduced in the mid-1990s. Some studies have shown they have a success rate of greater than 80 percent in reducing a patient's viral load, which impacts the ability of opportunistic infections to take root.

Not that Daniel knew that when he first learned he had contracted the virus. "When I tested positive, I was devastated," he says. "I was so scared, I put off getting treatment for a couple of months and was hospitalized with pneumonia. My T-cells were down to around 70, my viral load was very noticeable, and I had Kaposi’s Sarcoma lesions all over. But they gave me the medication, and within a couple of weeks, my load was undetectable and my T-cells had shot up to 300. It was pretty remarkable."

The drug regimen, over the years, has also become more manageable. "I still hear stories about people who had to take seven or eight different pills every other hour," Daniel says. "I take four per day." And he knows more recent patients who need to take only one pill daily.

Daniel calls the first generation of HIV-positive men true heroes in the fight against AIDS. "I had a friend who tested positive in 1986, and he's gone through the whole gamut of medications. He had to give himself AZT injections in the morning that made him throw up. For years, that was a daily ritual. But with the new medications, he's doing better than ever."

While his prognosis is good, HIV has obviously still had a major impact on his life — but not all, surprisingly, for the bad. "In a weird way, I feel like my life's richer," Daniel says. "Because I don't waste as much time. I sweat the small things less, and when I get depressed, I'm able to turn it around more quickly. Knowing there are things much more devastating than some of the trivial problems I used to worry about has given me perspective."

He has also become a fan of the human race. "I couldn't believe how people responded when they found out I was positive. I'd be walking down the street and they could tell because I'd lost weight. They'd be grabbing my hand and comforting me. I've found there's a kindness and empathy to people that’s astounding. 99 percent of people are really good to the core."