Jason Reid: It´s Not all Live, Laugh Love

HIV HAS CHANGED, BUT IT’S NOT ALL LIVE, LAUGH, LOVE

By Jason Reid

I’m writing this as someone who has been HIV negative, HIV positive, diagnosed with AIDS, and now HIV undetectable. That’s important for me to say at the outset because I believe in writing from experience as much as possible. In the 16 years since I was diagnosed and admitted to hospital a great deal has changed with regard to the sexual politics of people with HIV. Much of which is due to two things. Firstly, PrEP (Pre-Exposure Prophylaxis) – a groundbreaking treatment that comes in the form of a pill which is taken pre-exposure to prevent HIV.

PrEP does not protect against STIs such as gonorrhoea, chlamydia, syphilis and hep C. Despite this, on the whole, I believe PrEP is a significant force for good. It encourages sexually active people to be purposely proactive in taking control of their own sexual health. You’ve probably seen articles and/or ads for PrEP all over the place.

Before PrEP, and when I was first diagnosed, the safe sex message was always centred around condoms. Condoms would – and still do – reduce the risk of passing on HIV and STIs. So why do I rarely see them mentioned anymore? PrEP is now the fashionable alternative that’s become like a must-have accessory, and that’s good, it proves that the messaging has worked. But perhaps condom usage should be amplified as well? Talking as a layman, isn’t it just common sense to continue some condom messaging alongside PrEP in order to reduce the rise of STIs? Whether people want to use them or not is another personal choice matter altogether.

For me, it’s about having full confidence in the sexual health organisations to empower people and authentically spell out all risks and ways to avoid them in order for them to partake in a fulfilling and mindful sex life.

“You don’t have to keep up with others peacocking on social media to feel like you’re achieving with your HIV management. If something makes you feel inadequate or marginalised, remove that barrier. Your mental health is too important”

It´s disingenuous to suggest that PrEP is the magical solution. Yes we need hope, but we need it with a hefty dollop of pragmatism.

I’ve been HIV undetectable since 2009. Pretty damn incredible – from a CD4 count of nine when I was in hospital with weeks to live in 2005. Which brings me on to the second thing that’s changed the lives of people with HIV immeasurably in recent years: those who are on effective antiretroviral treatment with an undetectable HIV status for six months or more do not transmit the virus though sex – undetectable equals untransmittable which is also known colloquially as U=U.

U=U has now become the ultimate goal. The pinnacle of HIV health. Like PrEP, the messaging is everywhere. Personally I’m delighted that it has been such a success, and has changed many people’s perceptions of HIV. I didn’t really try to achieve undetectability to be honest, it just happened as a result of years of adhering to my combination therapy. But what about those that can’t? Are they being supported and represented? Do they now feel like they’re

under constant pressure to attain the HIV ‘norm’ of U=U? These things can become incredibly overwhelming. I remember how bad my mental health was after I came out of hospital, quite bluntly I was a wreck for years – and that was before all the wall-towall jubilation about U=U. Not sure how I’d cope now. In fact, I’ve friends who didn’t develop AIDS-defining illnesses who also suffered terribly with their mental health in recent years because, in part, they felt at odds with the wider conversation. It feels like some orgs have been taking the live, laugh, love approach to portraying people living with HIV. Which I can understand, given our history.

“It’s disingenuous to suggest that PrEP is the magical solution. Yes we need hope, but we need it with a hefty dollop of pragmatism”

A few years ago I wrote a piece about being proudly positive, and this is a stance I will always take. HIV is something that is now part of my very being. In the same way that being visibly gay is. Choosing to live this way, while also understanding the benefits of my undetectable status, is, for me, a political act – one of subversive liberation that hopefully serves to break down HIV stigma.

To those reading this who are not undetectable and are struggling, I want you to know that you are no less than any of those carefully selected people in the glossy ads who are “living a great life with HIV”. You’re a warrior. You matter. Even when it feels like you’re being completely left out of the conversation.

A phrase that has served me well that l like to refer to when I’m feeling low is “comparison is the thief of joy”. Life is not a glossy ad, popping a pill and everything is fine, and becoming undetectable is not the be-all and end-all. You don’t have to keep up with others peacocking on social media to feel like you’re achieving with your HIV management. If something makes you feel inadequate or marginalised, remove that barrier. Your mental health is too important. There’s a lot more nuance to living with HIV, and I think modern-day life is becoming more and more bereft of nuance. That’s something that desperately needs to be clawed back. Yes we’ve made great strides and we should pat ourselves on the back, but let’s not kid ourselves into thinking that everything is hunky dory for everyone. Let’s keep it real. Let’s raise every voice.

We’re all HIV positive, and no one should feel marginalised.