Sunday Times (Johannesburg) - May 14, 2006
Peter Damm

'I WILL now give you the test result ...and the result is positive." These words were spoken to me by an HIV counsellor at the Durbanville Clinic last October. It was the Monday that my passport had arrived. After two months of planning, my flight to teach English in Taiwan was finally a mere week away.

The forms from Taiwan warned that I would receive a medical examination upon my arrival, and inquired when last I had been tested, but this footnote was more like a formality than a real necessity.

I was in a happy, jovial mood as I marched into the clinic. The world was my oyster and this would be the final prudent act of quaint responsibility.

As I waited for the results, some doubts crept into my mind. I remembered mentioning to my mother several months earlier that I should be tested because I was always feeling tired and washed out. I remembered her dismissal of my fears, which I subsequently used in my own internal dialogue. Everyone gets tired and one should just get on with things without thinking or complaining too much.

Besides, I had tested negative several years before. Although I was gay, I hardly led an active sex life, and I often preached to friends who were involved in casual sex about the dangers of becoming infected.

Yet, a nagging doubt remained. There was that one time I had unsafe sex about three years before. The person was a bank manager, well-known on the gay scene, and healthy looking. He had negative test results from a home-test kit.

Nevertheless, it bothered me that he had a chest full of pornographic films and sexual gadgets, yet he claimed not to have any condoms.

But I believed him when he sweetly insisted that he was HIV-negative. While the guilt of the unsafe encounter put me off any sex, I refused to believe that anyone would purposefully infect people, or that one unsafe encounter would result in infection.

I was confident and self-assured as I sat down to face the counsellor.

After the news, time froze for several seconds, as my whole world collapsed. My first reaction was one of disbelief. For a moment I really thought the counsellor was joking. I expected him to break into a broad smile to apologise for the cruel humour.

Nothing can really describe the horrific emotions that followed. Each lengthy back-up test replayed some of the trauma, as the hope that it was all some terrible mistake was dashed repeatedly.

Now, just over a year later, there is only one thought that horrifies me more than the memories of the diagnosis. This is the thought that I might have forgone the test. Although I am not generally a person who follows one religion, I can only say that "the Lord" works in mysterious ways. One of my initial reactions was to rage at the universe. In a sense, I believed that God had abandoned me.

Although the test was traumatic, it was a setback I could eventually handle with the support of my family and friends - especially as my research on HIV/Aids broadened.

I still live with a bit of that trauma every day, but the alternatives would have been so much worse. I would have gone to Taiwan to be tested there, possibly without counselling, only to be sent straight home.

Perhaps, somehow, I could have stayed there or even avoided the test - only to struggle alone with inexplicable fatigue and a range of serious tropical illnesses. The point is that I still had my family and friends that day and the days to follow.

The thought of walking about every day with the virus without being aware of it horrifies me. I could well have infected somebody else by now. I may even have donated blood.

But this is the problem. Some people are careless, and others simply don't care. Everybody thinks that it cannot happen to them. Some people are insulted when one advises them to get tested, while others admit that they are too scared.

Apart from the risk of infecting other people, there is the terrifying risk that one may be diagnosed too late. Although statistics are problematic in a nation living in HIV denial, it is shocking to hear that over half the people who test positive are only four months away from full-blown Aids.

The progression of the virus is different in every individual. The stages of HIV must be established and monitored until ARV treatment is advisable. Furthermore, ARV treatment requires certain lifestyle and mental adaptations that are better introduced over time. The sooner one knows one's HIV status, the better for yourself and the people around you.

Ultimately the choice of whether or not to be tested is up to the individual. One of my acquaintances knows he has had lots of unsafe sex. Therefore he will not get tested because he will just "kill himself" if he tests positive.

To such individuals I would say that HIV is now a treatable condition. The suicide rate is much higher for people who already have full-blown Aids when they are tested.

Indeed, leaving things to the last moment can be suicidal. What is ironic is that this person may be HIV-negative. Some people may lie awake worrying about their status unnecessarily.

I can understand the immense fear that leads to denial. Only somebody who has been there will know how easy it is to pick up the virus under certain conditions, particularly unprotected penetration - and one does not have to belong to a certain sexual orientation, gender or race.

Going for an HIV test every six months should be routine for everyone. One is more likely to act responsibly if one tests negative. The test itself can be a method of HIV prevention.

Unfortunately, apart from a few examples of dependable public figures that are tested as an act of HIV activism, our political and religious figures have let us down by refusing to lead by example.

Getting tested is one way of showing solidarity with the victims of Aids and the struggle against the pandemic. What naughty things have these fearful people been up to?

So, yes, the test caused me trauma and pain. For a while I immersed myself in the works of the Aids denialists. In one book I found some good points, but ultimately just hatred against the whole medical establishment, personal insults, unfounded comparisons between modern doctors and Nazism, and, ultimately, no explanation of why so many people are living long and fruitful lives on ARVs.

In the British and American gay press I read account after account of people who were at death's door and are now leading normal lives on ARVs. Unless all these people are in on a conspiracy theory, the denialists have some explaining to do.

Ultimately, the most sincere proof of their convictions would be if a few of the denialists injected themselves with HIV serum. No such gesture has been forthcoming.

To conclude, I can only say that one can hide from the test, but not the truth. If you are infected with HIV, you will know about it sooner or later. Ignorance does not buy time, it wastes time. Do not leave things until you have to face a vengeful partner or former lover who you have infected. Do not wait until you have Aids-related conditions, or until ARVs are no longer useful to you. Make sure you have time to plan your life.

By getting tested you not only rob the virus of its weapons of fear and secrecy, but you also make the infected feel like we are a part of an all-pervasive struggle against HIV/Aids.

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