“Charlie, I can deal with the gono, it can be treated quickly and easily as soon as it’s diagnosed, but this is a bit more serious, yeah!?” I feel like the emphatic urgency in Tom’s ordinarily reassuring tone is an indication of where his head’s at. Sitting beside him, there’s a temptation to wander off into soap opera style fantasies that put me as the main character wearing his shoes. But this is not my drama. I’m just here to support my best friend while he battles believing he’s becoming HIV positive.
The clinically dull waiting room has the kind of chairs that look inviting, but are evidently not designed for prolonged comfort. Positioned opposite, a young woman drops the glossy magazine she idly flicks through. As she picks it off the floor, I fleetingly catch her eye, wondering if it was Tom’s swearing or mention of an STI that caused her to flinch.
For a Saturday morning, the clinic isn’t as busy as I feared it would be. God knows what Tom’s feeling like in front of everyone; though he’s not exactly the shy, retiring type. As much as I admire his typical fortitude, I have no desire to trade places with him right now.
I reply with a hushed, measured tone “OK. We don’t know that anything’s serious yet… besides, you’re here doing something about it right now. This is the best place for you to be. It’s Blake. He’s undetectable – you won’t need PEP.” My accidental upwards inflection isn’t meant to make it sound so much like a question. The young woman glances up one more time, but Tom seems oblivious even if I’m not.
It’s Blake. He’s undetectable – you won’t need PEP.
“Am I though?” snaps Tom “Blake blows a load in me every time we fuck and I have zero bloody knowledge of how long he’s had fucking gonorrhea for!” Turning closer towards him I notice someone in my peripheral vision fidget awkwardly. But by now it’s pointless obsessing over what anybody else in earshot thinks about the situation. In spite of my own neuroses, I need to focus on supporting Tom. Right here, this isn’t about anyone else. What’s already been a 30 minute wait for an emergency appointment feels like an eternity.
It’s no secret my best mate’s fuckbuddy, Blake, has HIV. He’ll be the first one to tell you about what he calls his ‘fabulous disease’ – a nod to some blogger from his US hometown he gets all gushy over. I can appreciate what Tom sees in him. Unapologetic, outspoken and fine looking all American boy through and through, plus emotionally intelligent to boot. I think he’s the first openly HIV positive guy I met who talked about what it means to be undetectable. Back when he and Tom first started fucking I think I’d heard of it, but didn’t really understand it means he can’t pass on HIV.
“But he’s undetectable. You know that, and you know what it means.” Despite his frantic phone call earlier begging me to join him for a date at the clinic, I’m still not fully getting what he’s hyped about. Tom’s cool about HIV and sex stuff. More so than most of the guys I get with. I feel dumb and a little apprehensive about digging around his anxiety but I guess living it firsthand emotionally is different to looking at it from the outside.
“Charlie! For fucks sake! Do you really think I’m not aware of that? We’ve been barebacking for months now.” Tom blurts it out validating my feeling of ignorance, but not adding any clarity. I request he spells it out for me “Yes buddy, I know. And you’ve been cool with it. So what’s going on right now?” It’s asked honestly.
Exasperated, Tom curtly leaves his reply hanging awkwardly in the air “Because what if the gono makes his viral load spike and he’s detectable now? Then what?”
For once, I don’t have a smart-arsed answer for my best friend. For all my usual verbal diarrhea, I’ve got nothing. I reach out and gently squeeze his arm, as if somehow a simple display of camaraderie will make it all better. I genuinely wish it would.
Because what if the gono makes his viral load spike and he’s detectable now? Then what?
An enthusiastic young doctor breaks the atmosphere calling in a patient, but it’s not Tom. I feel the urgency of his anticipation. Rather than sit in silence I feel it’s best to encourage him to talk it out.
Sitting by my side, his eyes fixated on the neatly arranged squares of ugly, durable carpet, Tom explains how Blake phoned him not long after leaving his place this morning. They’d spent the night together. The first time since Blake got back from a trip back home Stateside. Blake went for sexual health tests earlier in the week and got a call from his clinic first thing this morning – he’d tested positive for gonorrhea.
Tom and Blake don’t define how they operate in terms of a ‘relationship’. They just do their thing, hang out, make out and fuck. They seem happy to me. And part of how they work means sometimes they fuck other guys too. We’ve all sat in my modest apartment swapping war stories about ‘extra guests’ we’ve inadvertently brought to the party. I never had friends that I felt so comfortable talking about STIs with.
But for Tom here and now, this is the first time Blake’s potentially passed one on to him. For all his knowledge and usual comfort to bareback with someone who’s undetectable, Tom’s fear of sharing an HIV status with someone he appears to love is on display and all too real.
As I listen to him speak, the background noise of the waiting room fades out and I find my eyes staring into space, arranging the pieces of information into something I’m trying to make sense out of. Something in my brain sharply snaps my attention back in to the room. My focus suddenly intent on the dog-eared poster pinned above where the glancing young woman is still reading her magazine. It proclaims ‘HIV + Syphilis =
UnDetectable. Syphilis may increase the amount of HIV in cum and pre-cum.‘
Any intention to process the situation rationally is overshadowed by uncomfortable feelings of empathy. I get where he’s at.
“Look, you don’t know Blake didn’t pick this up while he was away. It could just be a recent thing. Even if his viral load is up – which you also don’t know for a fact – you’re still within the time limit for PEP to do its thing.” As this lingers in the air between us I wonder out loud what Blake’s take on it is “What did he say about how this affects his HIV?”
Tom’s body shifts noticeably in the chair. Did I touch a nerve? “He didn’t say anything… I didn’t ask. Man, I was barely holding my shit together on the phone with him. What kind of message does it send when I’m freaking the hell out over whether he’s given me HIV or not?” For all the anxiety over his own personal circumstances, the prioritisation of Blake’s feelings in all of this is as immensely admirable, while also intensely frustrating to behold.
I reply “So… I’m not Blake, and I don’t have HIV. But if he’s anything to go by, he’s doing just fine. And I’m very fucking sure he’d be heaps more sensitive about informing you if for a second he believed you were in danger.”
Tom relies on a crutch of sarcasm to volley back “Oh, thank you for reminding me I’m overreacting here. Nice.”
But I’m not playing “Buddy, I get this is about you and you’re scared right now, but Blake is very much alive and well, and so are you…” Testing my position as best mate to serve with the slightest hint of a wry smile and just one eyebrow raised, I add “Even if you are riddled with gono.”
My risky comedy move pays off and is met with a friendly “Watch yourself!” before he continues his stream of consciousness. “I feel awful for doing this. How can I tell him I was so scared of him? I’m sorry Charlie. This is not where you wanted to be on a Saturday morning.”
I feel awful for doing this. How can I tell him I was so scared of him?
With permission to jovially shift the mood cautiously granted, I push him further “You’re all good buddy. This is all gonna work out fine. Hey, once this is all over, remind me to kick your ass about handling Blake with kid gloves. Talk with him! You guys are great.”
Any witty retort from him is cut short by an older, softly spoken doctor “Thomas”
With a reassuring smile and the gentlest of nods in Tom’s direction as he rises, I’m left with just the company of my own thoughts and the returning temptation to selfishly contemplate what if I were him. What if I meet my own Blake? Is the comfort of all my knowledge enough for me to be intimate without being afraid?
It’s too warm in the waiting room. My mobile phone seems like a good distraction and a way to avoid the social awkwardness until Tom returns. Hopefully with PEP.
It’s been a month now. Tom just finished his course of PEP this week. Apparently they wouldn’t normally give it to him as Blake has been undetectable for more than six months. But knowing Tom’s determination and the concern over gono, he got it prescribed anyway. His test results are all fine so far, though the next one is due in two months. That should put him in the clear, but emotionally he’s good.
He already knew about PrEP, but the doctor suggested Tom think about it as an ongoing HIV prevention strategy anyway. Even though he’s safe getting fucked bareback by Blake, I know he’s thought about it with other guys, even if he’s promised he hasn’t done it so far.
He and Blake did talk. They’re cool – better than ever. Blake was amazing about the whole thing. He even explained to me that for his many years of being on treatment, any STI he’s picked up hasn’t ever resulted in him becoming detectable. He reckons the tests show undetectable every time because he’s so regimented in taking his meds. Though he did emphasise the importance of getting regular tests to ‘seek and destroy unwanted stowaways’ as he puts it.
As for me, I fucked a few guys. Nothing unusual. The PrEP dude I met a few months back who was hell bent on fucking me raw hasn’t been so chatty of late. I guess if his other conquests offer it up without a rubber, guys like me may not be as appealing to some. Still, I’m doing just fine. I mean, I could go on PrEP, but I don’t know how I feel about doing it just so I can fuck raw. I dunno about that. Maybe something will change. I guess I’ll cross that bridge when I come to it.
PEP is a one-month course of anti-HIV drugs intended to prevent someone from acquiring HIV after possible exposure to the virus. For PEP to stand a good chance of working it must be taken within 72 hours after exposure, and ideally, as soon as possible. The Get PEP website has information on how to get PEP closest to wherever you’re based in Australia. You can also read our introduction article, PEP – Protecting you against HIV when you need it.
For people living with HIV who aren’t on treatment, having an STI such as syphilis can cause an increase in viral load. However, for people who are currently on HIV treatment, STIs appear to have no or very little impact on viral load.
The current scientific consensus is that the risk of HIV transmission from a person living with HIV, who is on antiretroviral therapy and has achieved an undetectable viral load in their blood for at least six months is negligible to non-existent. UVL 101: Undetectable = Safe provides more information.
Charlie’s previous story involves negotiating safe sex with a PrEP user: He told me he’s on PrEP and wanted raw sex, here’s what I said. His next story involves his first sexual experience after choosing PrEP: I’ve just started PrEP, here’s how my first hook up went
If you’d like to know more about many of the topics raised in this story, check out the following articles:
- Five reasons to jump right in, regardless of his HIV status
- Introducing PrEP – The little blue pill making a big impact
- Why can’t everyone just use a condom?
- Serosorting: How’s that for a fucking strategy?
If you’d like to learn more about HIV prevention, treatment and other sexual health matters, contact your local LGBTI health organisation listed in our partner network.