AIDSiversary: 24

Well that really sneaked up on me! I have been so (rightly?) focused on the latest pandemic raging around me — and it’s truly raging at this particular moment, with each day bringing record new infection counts — that I have not been quietly reflecting on my other pandemic experience.

Yes, COVID year two, but for me, HIV/AIDS year 24 on the personal level and year 40 on the broader North American level, if you exclude the historical reconstructions that show how this particular virus made its way from some isolated valley through new urbanization and global travel to reach the world. It all happens way faster now, but in the same kind of way. It shouldn’t be a surprise that there are isolated viruses in out-of-the-way places, and that our globe-trotting ways help those viruses travel the world with us.

It has been difficult to watch the lessons we have learned (should have learned?) from HIV be discarded in the current context. Yes, there is no comparison between how HIV and COVID are transmitted, the latter being excessively easy, but there I no excuse for not first thinking about how various measures will impact the most vulnerable or how poor choices of words can have lasting negative effects.

Ticketing homeless people for being too close to each other when they have depended on proximity to others for mutual help and survival is completely ridiculous. Not to mention that those tickets will never be paid, and only represent an additional barrier to re-entry into society. The one that makes my blood boil every time I hear it: “Social distancing”. When some public health authorities realized the error of the expression — we need physical distancing and social solidarity — it was too late, and the expression has become ubiquitous.

Those kinds of mistakes have lasting negative effects.

Early errors in naming what was happening stigmatized communities and further stigmatized any frank discussion about sex and drugs that we know now are necessary to actually doing effective prevention. Not listening to the communities who are the most affected makes us miss the pragmatic approaches that could save lives. The condom strategy in HIV came from a community unwilling to accept recommended (and unrealistic) abstinence, and it worked quite well. The community had to push and pull to get recognition of the fact that low viral loads in HIV make it impossible to transmit. Yeah, yeah, science will never say impossible, but let’s be realistic about our assessment of risk in a world that is full of them: we don’t insist on the freak car accident as proof that walking on the sidewalk is dangerous.

So I’ve now ranted myself off topic, but there you go.

Twenty-four years after my diagnosis — with AIDS-defining pneumonia and a CD4 count of 4 — I am alive, I’m working full time, and HIV is not my central health problem. It certainly has an impact on my other health decisions, like not hesitating with vaccinations and being extra cautiously isolated, but I’m now getting old and having those age-related problems I didn’t really believe I would have, that day in 1997 when I got the news.

One lasting feeling from that time and how I experienced that pneumonia: while I accept that I might die earlier than other members of my family (I say this as someone diagnosed too late to completely recover and too early in time to have all of today’s medical advances), I know that the worst thing is to choke on a lack of breath. That is not how I am willing to go, so I will continue to be vigilant and maybe even over-vigilant in my following COVID rules.

See you next year, twenty-five.