Like many HIVsters, I’ve made ample use of therapy; both personal and group, at times simultaneously. One might add that I am, or was, therapy-naïve – never saw much use in it, and this particular extravagance was more for the camaraderie and the drinks after it was done. In one such group session – here at Gay Men’s Health Crisis (GMHC) in New York City -- the facilitator (I believe that’s what they’re called, others go by ‘moderator’) mentioned a concept that had me spitting nails: the idea that one should develop said HIV identity. It would help us ‘get in touch’ with the supposed turmoil within.

Well, no, I said. I neither need nor want that. My identity doesn’t include an accidental disease, and I don’t do turmoil. I speak French, read books, cook, I’ve walked down Fifth Avenue in nothing but a pair of combat boots, Calvin Kleins and a big smile, am active in politics, write stuff people actually read, I’ve even met the President of the United States – the current, sane one, not that hot mess we had until three years ago. I’m a New York hipster, for crying out loud. That should suffice to establish a secure sense of self. And just who the fuck do you think you are anyway?

So, no, I don’t have any use for this particular bit of thera-blather, I said as nicely as I could. Which still, if memory serves, wasn’t all that nice. The way I was brought up – military family, you do the math – boys don’t have feelings to begin with. If you have a problem, you sit down and work on it. You certainly don’t talk about it with mom, or dad, or your friends, and if that problem resides below the waistline where the icky parts live, you’re definitely going to mind your manners and remember that polite company is wherever you happen to be. All very British, if you will, or German, rather, because that’s my actual background. If you know anything at all about that particular ethnic group, aside from their utter lack of humor, it’s that our ‘therapy’, such as it is and Freud be damned, consists of invading defenseless neighboring countries.

And all of that served me quite well, thank you very much, for a long time. Granted, being a slab of meat devoid of detectable emotion can cost you. Say, a stunning man you’re still in love with twenty years later and an ocean apart, the one you never told just how much you love him.

I find, however, that people who vigorously disclaim something – I tend to be one of those – do so for the simple reason that someone has struck very near a mark, and  continue thinking about and watching what goes on around them. And so I did. I watched those young kids, clearly terrified, walking into GMHC for probably the first time. I had a friend break down in tears over not having anyone to talk to about his status but me, not his family, not his other friends, no one in God’s creation. Just me. That other pretty young guy, maybe half my age and worth his weight in gold, crying on the street. Or that poor transgendered woman who had just had the stuffing kicked out of her by the ‘real’ women in the homeless shelter, with no idea where to go next. Just heartbreaking, and yes, I do have one. Somewhere.

I forget when it was, sometime two summers, I suppose, when the flip-side of the Anglo-Teutonic iciness came out; and that is, simply put, the idea that one has a duty to be there for others. The idea of duty is, I believe, one of the strongest moral forces in our world; it’s why we pay taxes and at least try not to break laws. Judaism has a very useful concept for that called ‘Tikkun Olam’, ‘Repair the World’ in Hebrew. The idea, once you strip it of all the extraneous religious verbiage, is simply this: that as human beings, we live in a society, and have a positive moral obligation to make it better for everyone. As in, stop talking, take action. So far, so good, and all emotional aloofness aside, I personally actually have a pretty good track record on that; leftwing activist and all.

I decided that my duty was to be as open about my HIV status – positive, in case you’re wondering – as I could be. That’s one reason why I write here, on Daily Kos, on Alternet, and probably more as this journey progresses. One other reason is, of course, that I like to hear myself talk, but my editors have learned to live with that, bless their hearts.

But talking alone isn’t action, is it, unless you calculate the value of being out and, God alone help us, maybe being a role model for some kids none of us may ever know. Stigma is still out there, it ruins lives, and it pisses me the fuck off.

I decided to cancel my therapy group just recently. It was getting tiresome anyway, and frankly, I’m not all that interested in the granular details of the sex life of strangers (unless I plan on being a part of it, but that’s a story for another day, and most certainly not applicable in that particular context). Instead, I joined ACT UP New York, the mothership, still around after all these years. And guess what? ACT UP still gets stuff done. Amazing, that, and I get to be a part of it.

So I guess that’s my HIV identity: I’m very much okay with everything, and so is everyone around me. I’ve done a few small things for other HIVsters, nothing to write home about, not yet at least. I’m healthy as a horse, my career is getting back on track, my relationship is solid, you get the idea. I’ve stepped out of the shadow of the disease. I’m in charge now, not some virus.

I suppose that’s the moral of the story and what my facilitator was talking about. You’ll have your own HIV identity when you own the disease, not the other way around. I really do believe that everyone can get there; and meanwhile, never shut up, raise hell, and if anyone tells you it can’t be done, laugh in their face. Because it can.

Genesis 19, KJV:

1 And there came two angels to Sodom at even; and Lot sat in the gate of Sodom: and Lot seeing them rose up to meet them; and he bowed himself with his face toward the ground;

 2 And he said, Behold now, my lords, turn in, I pray you, into your servant's house, and tarry all night, and wash your feet, and ye shall rise up early, and go on your ways. And they said, Nay; but we will abide in the street all night.

 3 And he pressed upon them greatly; and they turned in unto him, and entered into his house; and he made them a feast, and did bake unleavened bread, and they did eat.

 4 But before they lay down, the men of the city, even the men of Sodom, compassed the house round, both old and young, all the people from every quarter:

 5 And they called unto Lot, and said unto him, Where are the men which came in to thee this night? bring them out unto us, that we may know them.

 6 And Lot went out at the door unto them, and shut the door after him,

 7 And said, I pray you, brethren, do not so wickedly.

…into an epic spat of genocide.

24 Then the LORD rained upon Sodom and upon Gomorrah brimstone and fire from the LORD out of heaven;

 25 And he overthrew those cities, and all the plain, and all the inhabitants of the cities, and that which grew upon the ground.

 26 But his wife looked back from behind him, and she became a pillar of salt.

 27 And Abraham gat up early in the morning to the place where he stood before the LORD:

 28 And he looked toward Sodom and Gomorrah, and toward all the land of the plain, and beheld, and, lo, the smoke of the country went up as the smoke of a furnace.

And just to make sure the point came across, in case the leveling of entire cities wasn’t clear enough, the rulebook makes special note of the Almighty’s general disapproval of the whole man-on-man thing, pretty close to the part where He warns against the poor, misunderstood shrimp.

Or so we have been told ever since Constantine the Great decided to make Christianity the state religion of his teetering Roman Empire, putting an end to classical antiquity’s far more liberal views on same-sex relationships and the status of queers in society. All the mechanisms of oppression were put in place by these texts and the authorities that interpreted them for the common folk.

But do the texts really mean what they say at first glance?

The simple fact is that they likely do not. The real sin of the randy men of Sodom wasn’t so much their desire for a quick roll in the proverbial hay with some fresh meat, it was their transgression against the laws of hospitality, the absolute requirement that the stranger be treated well. That is kind of the theme of the entire book, if you sit down and actually read it. Not quite as altogether awful as some people – I’m looking at you, Rick Santorum – would make it.

But you don’t need to be a believer –I’m not, most days – to see that we as a society still have a long way to go when it comes to opening our doors to the stranger. And I would really like to know just how exactly anyone – Christian, Jew, Muslim, you name it – can reconcile the demands of their faith with excluding anyone from their rightful seat at the table.

Like, say, the thousand queer and trans kids whosleep on the streets of New York City every night, with an HIV infection rate that staggers the mind. No seat at the table for them, I guess; or even a roof over their head.

These kids aren’t strangers in any sense of the word. They are our children. And they need our help. If you can, please give.

I’m sure the Lord won’t mind.

In November of 2010, The New York Times wrote, under the headline ‘An AIDS Advance, Hiding in the Open’, about what at first and even second glance appeared to be a major step forward in HIV prevention: Pre-Exposure Prophylaxis, or PrEP.

In the war against AIDS, a new weapon has emerged.

It wasn’t a secret weapon. It was a well-established treatment pill that has only now been shown to be effective as a prevention pill too. Which raises a question: What took so long?

Last week, a clinical trial showed that taking Truvada, a pill combining two drugs, once a day would greatly reduce a gay man’s chances of getting infected with the dangerous virus. Although confirmatory studies are still needed, the practice — called “pre-exposure prophylaxis,” or “prep” — will, in theory, also protect sex workers, needle sharers, wives of infected men, prison inmates and anyone else at risk.

Truvada, along with other drugs, is already in use for post-exposure prophylaxis and in HIV combination therapy, presently the standard treatment for those infected with the virus.

Recently, however, the AIDS Healthcare Foundation has petitioned the U.S. Food and Drug Administration (FDA) to reconsider giving the agency’s approval for the use of the drug in a preventive context. AHF used a rather novel argument:

"Any approach that relies on adherence for people who don't have a disease is going to fail," AHF President Michael Weinstein said at a press conference on Thursday.

‘Relying on adherence’ is precisely what HIV prevention has been doing for three decades. Use protection, every time. Every. Single. Time. Without fail.  In other words, we took what is in most cases a voluntary and spontaneous process, intercourse, and added a dimension of required control to it. There is not, however, a single system one can think of engineered by human hands that is entirely fail-safe. A few years ago, the entire electricity grid in the Northeastern United States went dark for several days, causing billions of dollars in damages; that grid, however, is one of the most complex and most stable systems on the planet. It powers hospitals, the money factories of Wall Street, even the nerve centers of another kind of power, the matchless military force of the United States.

So it really shouldn’t surprise anyone that prevention is a bit of a problem, nor that statistics bear that observation out. For many gay men at least, the idea that in our most intimate moments, we would need to have, as an absolute and non-negotiable necessity, the foresight of mind to treat intimacy as a potential threat, was and remains a challenge. It’s not that we don’t know what constitutes risky behavior; it’s that it’s simply not possible to always avoid it, or in a given moment even desirable. Walking a red light can get you killed; it can also get you to a job interview on time.

Sex is really no different. You make choices, some of them well-informed, some less so. The calculations of risk and reward may not always seem as balanced as the rational mind would make them. The phenomenon of condom fatigue is very real.

I’ve had several conversations recently with people in the AIDS activist movement about a perceived shift in that risk-reward calculus. Simply put, they – we – find ourselves needing to communicate two messages that are at odds with one another. On the one hand, externally – that is outside of the HIV community – we need to raise awareness of the risks inherent in unprotected sex and other behaviors, and to unsubtly convey that, as has been said, “HIV is still not a day at the beach.” Because really, it’s not. Chronic or inevitably lethal, a major illness is still just that.

On the other hand, you have, say, people like myself with great skin, gym memberships, families and friends, the whole nine yards of modern gay life. In short, not the picture of devastation those of us of a certain generation remember all too vividly. But this message – that there is a life with HIV, and that it can be a good one – is precisely what we communicate internally, within the HIV community. We’re saying, “fine, you have it, here’s how you can live the full life you want and deserve.”

That’s a classic binary, a contradiction in terms, isn’t it?

I would posit that resolving that binary, squaring that circle, is the biggest challenge we as a community will face in the coming decade. But whatever strategy is developed, however many arrows are in that particular quiver, will need to take into account that the fright factor is no longer the omnipotent answer it was even a decade ago.

Follow @MichaelBouldin on Twitter

http://www.michaelbouldin.us

(Image: National Aeronautics and Space Administration)

New York City, March 5, 2012

Hey there, PositiveLite readers. Hope your day is going well. Mine certainly is, and if you don’t terribly mind, I’d like to tell you why that is so, and how I came to write here. Many thanks, of course, to Bob Leahy, who’s given me the chance to do so, which is, you know, exciting.

He’s also asked me to introduce myself, which seems only polite, so here goes.

First, the basics. My name is Michael Bouldin, I’m a gay man living in New York City, forty-two years old, a blogger, and a social media junkie. Before moving to the City, I lived most of my life in Europe. I’ve been happily partnered now for eleven years or so, work out a lot, in short, the typical way of life of the red-blooded gay American male.

I also tested positive for HIV in August of 2009.

That sentence you just read is one I could not have published two years ago, for exactly the same reasons I declined an offer to be a poster boy for London Pride back in the nineties. Fear. Shame. Fear of exposing my deepest secret, the part of me nobody was supposed to see. In my early twenties, that secret was the fact that I was – well, still am – gay. My nose was already peeking out of the closet, mind you, but not to the extent that I would want it plastered fifty miles in every direction from Trafalgar Square advertising something gay.

Most gay people are probably familiar with that particular form of paranoia; just keep it quiet and hidden, be ambiguous, don’t flaunt it, because if you do, you’ll lose all your friends, and nobody will ever love you again. At least, that’s what you think, even if not a word of it turns out to be true.

To my complete astonishment, after that positive test result, I found myself in a new closet, and guess what: it works just like the other one. And oh, look, there come those old friends, fear and stigma, slithering back like some crashing bores you just threw out of your party. Once again, something to hide, something intensely personal but so much a defining part of yourself that it couldn’t, and can’t, stay hidden.

Let me to tell you a bit of the backstory. It’s really rather embarrassing in retrospect, but after I first suspected I was positive, I just couldn’t bring myself to take that test and have my worst fears confirmed. Better to live in ignorance and hope for the best. Seek some distractions. With George Bush in the White House and the country caught in the turmoil of two wars, there was quite a bit to distract yourself with. Shouting obscenities at the evening news on a daily basis comes to mind, marvelous aerobic exercise, really. The agony of the 9/11 attacks, meanwhile, obviated many private pains.

I grew up in the eighties. My years as a budding gay man coincided with the outbreak of the AIDS epidemic. I’m part of a generation that was taught – or if you prefer, bludgeoned with – the idea that being gay wasn’t just completely unspeakable, an abomination in the eyes of God and Man, but deadly. A very simple equation: you fuck, you die. And not just any death: a horrifying, swift, and ugly death. The images alone were devastating: people withered down to skeletons that wouldn’t have seemed out of place in Auschwitz. Walking corpses, given perhaps the small mercy of blindness, so they couldn’t see the cancers devouring their bodies.

I did not want to be a part of that. Nobody does, I suppose. But after I got sick and diagnosed, I really didn’t have much of a choice in the matter.

As a blogger – one of the first political bloggers in the State of New York, thank you very much – I’m used to living a public life. Bloggers tell stories; it’s what we do. Sometimes, we even tell our own.

But would I be able to tell this story, my HIV story? Several friends insisted that, yes, Michael Bouldin, you’re an advocate, now advocate for this. Like, you know, all those brave men and women of ACT UP, their rage blazing through the streets in a literal race with death. Silence is Death, they said, and they were right. Still are, when you think about it.

I most decidedly did not want that. In fact, there were some rather heated fights about the matter, but that’s a story for another day. Suffice it to say that I doubted very much whether I was hardened enough to face what I thought would be inevitable opprobrium, or whether anything was worth completely shredding my privacy for. In a word, much the same thoughts I had back when I was looking over my shoulder before scurrying into the gay bars.

I suspect that my first year living with the virus was much like everyone else’s. After the initial shock and panic wear off, you adjust. You design a new schedule, pop pills big enough to shame the Rock of Gibraltar, make new friends, at some point figure out the sex thing, and start telling people the news. In short, you put your life back together. It takes time, but it happens.

Throughout that process, something was gnawing at me: the idea that I wasn’t being completely honest, either to myself or to the people around me. A lot of people knew The Big News™, but others did not. How to keep the two groups separate? What story to tell, or what inelegant lie? Just how comfortable was this closet? And wasn’t there some obligation, noblesse oblige and all that, to use this to help others who may not have all the advantages I have?

I don’t know exactly how it happened, but one day in 2010, I woke up, here in the great, shining City of New York, sat down at my desk, and started to write.

I published the result on Daily Kos, the largest political blog in the world, on World Aids Day in 2010, under the headline I Am HIV Positive. It was a thunderclap. The piece went viral, was the most-read article on the site that day with hundreds of comments, and with a click of a mouse, put a face to HIV in the American leftwing blogosphere, starting a conversation about the virus that had never really happened before in that form. Short of renting a billboard in Times Square or running starkers up and down Fifth Avenue, there was no more dramatic way of coming out as poz. People still thank me for that to this day.

And fuck me, did that feel good. I’d do it again in a heartbeat; actually, that’s exactly what I’m doing right now, isn’t it?

But none of this is about me. It’s about you. About all of us, really; men, women, transfolk, black, white, poz, neg, rich, poor, or whatever other category of our species comes to mind. It’s about the stories we tell to each other and the rest of the world. It’s about speaking out and demanding to be heard. It’s about getting rid of the fear, shame, bewilderment, what have you, that come with that diagnosis.

We don’t need to see another generation burdened with that weight. They have nothing to be afraid of, or ashamed. None of us do.

 Cheers,

– Michael