Late at night, I research and write by myself so I can avoid confronting the fact that I am alone, typically until I pass out from exhaustion. Gradually through the evening, as sources for my stories and colleagues I’m collaborating with over long-term projects go to bed themselves, I’m left alone at my computer, occasionally Googling a fact that I’m curious about; tonight, I learned about the history of Prussia.

Thoughts randomly piece themselves together until a great idea hits me, I write it down, and then my aimless reading continues. Sometimes, I’m chasing a lead and poring over ethics complaints and campaign finance disclosure forms. Other times, I’m refreshing my knowledge of American or military history. And, tonight, I purposefully watched the digital clock on my computer until 12:00 AM hit to reach another year of sobriety from alcohol; today, May 6, is the day that I decided years ago that I was finally done with drinking. 

At one point in my life, I had a good job serving my community, a good partner whose boundless compassion and understanding was remarkable, a quaint suburban home, and a good network of friends with reputable backgrounds and even more respectable jobs. Yet, during that very same period of my life, and for years prior, I had generally functioned as an alcoholic.

Somehow, I had always managed to apologize away the missteps, the rare flashes of rage, and the endless sadness, literally bouts of uncontrollable sobbing, that inevitably ensued when I became drunk. At some inexact point years ago, however, the functioning component of my alcoholism started to disintegrate and more of my work was sloppy, more dinners with my husband were missed, more hangovers caused more missed trains, and, eventually, I lost the very thing that I so desperately wanted my entire life: love.

Jung said that we do not wish to hear someone say “I love you” but, instead, “I understand you.” And, for me, this is a truth that I have found only once in my life and that was because it was coupled with love. Sometimes, I will hear someone inexperienced with long-term relationships wax poetically about the perfect nature of his newest adventure; candidly, I indulge myself in these sophomoric romps to, feel, at least for a short while, capricious and giddy. Indeed, there is a fleeting joy in being, for all intents and purposes, idiotically infatuated. But, the one thing that I rarely hear and have never uttered in years is the sincere, and quiet, appreciation of imperfection inherent in love and understanding between two human beings: the pensive tics, the bedhead cowlicks, the sometimes terrible sense of humor, the earnest goodwill found in whomever you truly love.

These imperfections are the essence of the love that we truly seek, whether we know this or not is irrelevant because it is true. And, at one point in my life, I had this love. Though, being an alcoholic, and a particularly nasty, narcissistic one at that, I threw that all away in exchange for doing whatever I wanted to do. This is, indeed, the surest way to destroy a relationship.

Let no maudlin drunk or repentant (at least today) sinner convince you otherwise: we do things as human beings not because we are compelled by nature or illness but, instead, because we choose to do these things.

We cheat on our wives because we are lustful and, for some reason, decide to not have a candid conversation about a non-monogamous yet loving relationship. We steal from public coffers because we desire greater wealth and material instead of appreciating the things we have and choosing to live within our means. We belittle others because we have the power to do so and can feel better about ourselves in the process, and there is no complexity in our motivation anymore than there is complexity in the fact that we must sleep every night as it is our biological function. Whether or not we choose to resist these motivations, to instead cultivate the noblest components we are endowed with is entirely our decision. We are not powerless nor are we weak. On the contrary, we are empowered to deliberately make decisions that have inevitable consequences, be they good or bad.

And this is the most frightening part of being human.

If we are not compelled by force to behave in a terrible way, then we have chosen to deliberately defy our ethics and the better parts of our innate characters and have opted, instead, to give in to the most repugnant and damaging aspects of our animal nature. We become drunkards, drug addicts, narcissists, mean-spirited misanthropes, or, as is typical, whiny, weak-kneed explainers who would rather use these very tools of manipulation, drink for instance, to excuse away our behavior disingenuously rather than confront the fact that our characters are, at least for some of us, inherently predisposed toward unethical acts. This predisposition is not immutable; we can change how we behave and how we cope with life in order to focus our energies in more socially acceptable and rewarding ways. Some folks call this cognitive behavioral therapy; others call it Alcoholics Anonymous. Personally, I call it ethics.

As the years go by and the length of time between the last time I was drunk and “now” continues to increase, I realize that I know very little considering I have experienced so much. Oddly, my knowledge seems to have an inverse proportional relationship to my age and experience; and, this is unnerving. For if part of getting older is recognizing that you are fully responsible for your mistakes, then you must logically realize that you are where you are because of, mostly, your own actions combined with a small number of lucky encounters.

These small chances, these opportunities presented by chance, fate, or God himself, are often hard to identify, but they exist and your actions in response propel your own trajectory down one of many different paths presented to you.

Personally, I chose an unhappy path for a very long period of time, a path that unfairly involved others to a tragic degree. And, I cannot change this, nor can I possibly ever find redemption for these actions and words. Rather, I can simply try harder and hope that those opportunities I once had will present themselves again only in a more recognizable fashion with, I assume, a different set of characters. Hopefully, I will recognize these opportunities more perceptively than I did when I was an active drunk, otherwise I am destined to repeat my mistakes and the idea of happiness, of that love, will always be the dream that I put off every evening, opting instead to read about history or write about politics until I fall asleep.

Today, I am still sober. And, I am still putting off going to bed. Even so, it is much easier being alone sober than it is drunkenly sobbing. And, for that, I am glad I made the choice to continue my sobriety today. I expect that this will continue for some time; after all, you get quite used to not drinking and, interestingly enough, are sort of puzzled after a while why people drink at all, or why you did it in the first place. Then again, there is no puzzle to it.

We do these things because we want to do them.

This article first appeared on Josh's own blog here.

This article by Gus Cairns first appeared on aidsmap.com here.  

Data from two national sex surveys in the United States show that gay and bisexual men (men who have sex with men, MSM) reported significantly fewer sexual partners in the previous year in a survey conducted between 2006 and 2010 than they did in one conducted in 2002. This decline was consistent across most ethnicities and age groups, but was particularly marked, and statistically significant, in younger men aged under 24.

In contrast, the proportion who reported having condomless anal sex at least once in the previous year did not change between surveys. In the minority of men who also had sex with women, condom use fell markedly, but on the other hand the proportion of MSM who also had sex with women fell too.  

The proportion of men who tested for HIV or for sexually transmitted infections (STIs) in the last year did not change, although the proportion who had never tested for HIV fell.

The survey

The data come from the last two National Surveys of Family Growth (NSFGs). The NSFG is a survey of 15 to 44-year-olds; participants are contacted at random by phone but due to lower contact/response rates, people under 24, black people and Hispanic people are ‘oversampled’, i.e. a higher proportion are initially contacted than are in the general population.

NSFGs used to be conducted every three to seven years, but in 2006 a decision was taken to conduct interviews (by voice-assisted automated computer interview) continuously. This study therefore compared figures from interviews conducted in 2002 with ones conducted in 2006 to 2010.

NSFG interviewed 4928 and 10403 men in 2002 and 2006 to 2010, respectively. Of these, 197 and 272 reported having a male sexual partner in the last year – 2.7 and 2.1% respectively (this difference was not statistically significant, p = 0.1).

The results

The mean number of male sexual partners MSM reported in the previous year fell significantly from 2.9 to 2.3 between the two surveys (p = 0.035) and was more marked in men under 24 years old (mean 2.9 to 2.1 partners, p = 0.027). The number of partners also fell in men aged 35 to 44 from 3.0 to 2.2, though this was not quite statistically significant (p = 0.07).

The fall in the number of partners was statistically significant in men with incomes under 150% of the US federal poverty level (3.0 to 2.1) and in men living in suburban metropolitan areas (3.2 to 2.1) but not in city-centre areas (2.6 in both surveys). There were declines in partner numbers in white (3.0 to 2.5) and black (2.4 to 1.9) men, though these did not reach statistical significance. In general though, there was a consistent picture of fewer partners among most groups.

There were no changes in condom use for anal sex. In 2002, 57% of men had not used a condom the last time they had sex and in 2006 to 2010 the proportion was 58%. In the minority of men who also had sex with women, the proportion who had not used a condom the last time they had vaginal sex was 46% in 2002 but had become 67% by 2006 tp 2010, and this difference was statistically significant (p = 0.04). However, the proportion of MSM who had had female partners also decreased from 38 to 25% (p = 0.03).

One other notable difference was that fewer men reported transactional sex (sex for money or drugs) in the last year (down from 15 to 3%) and fewer men said they had injected drugs or had had sex with someone who had injected drugs (from 12 to 5%).

HIV and STI testing in the last year did not increase. In 2002 and 2006 to 2010, 41% of men said they had had an HIV test in the last year and in the case of STI check-ups 38% reported having one in 2002 and 39% in 2006 to 2010. The proportion of men who had never had an HIV test, however, fell from 25 to 15%.

Conclusions and comments

The researchers comment on the fact that HIV prevalence and the incidence of STIs increased in gay men during a period when numbers of partners and some other sexual risk behaviours were falling. They note that there have been previous studies in Seattle and Peru where STI incidence and/or HIV diagnoses have remained high even though sexual risk indicators in gay men have fallen. Studies of young black gay men in the US, including one recently presented at the 20th Conference on Retroviruses and Opportunistic Infections (CROI), have consistently shown that they tend to have fewer partners despite considerably higher HIV incidence.

The researchers speculate that this may be due to ‘network factors’: factors about partners that are not captured by the individual risk behaviour focus of most studies. For instance, some studies have found that black gay men tend to restrict sex to partners of their own ethnicity and are also more likely to have sex with men a number of years older or younger than themselves. Both of these would tend to concentrate HIV infection within the black gay community.  

Whether these are the main drivers of US black men’s greater vulnerability to HIV infection, another interesting aspect of this study is that gay men appear to have taken steps that could reduce their HIV risk by using a method that has received little emphasis in HIV prevention programmes for gay men – reducing their number of partners – while not increasing condom use, which has received the most emphasis.

Leichliter JS et al. Temporal trends in sexual behaviour among men who have sex with men in the United States, 2002 to 2006-10. J Acquir Immun Defic Syndr, early online publication, DOI: 10.1097/QAI.0b013e31828e0cfc, 2013. 

I think I am riding on a wave of good Karma and if that’s true, I am really enjoying the ride! It’s not a tsunami wave, it’s a simple, gentle wave with small things happening with large rewards.

Today, I went downtown for the raising of the Pride flag at City Hall. This is the first time I’ve done this, and I’ve lived here for the better part of 32 years. I went mostly because I saw a photo opportunity  - and I did get a few good ones. When I was wrapping up, I looked over my shoulder and there was a young guy watching me.

He began to tell me, “This has got to be one of the most powerful statements any city can make”, pointing to the flag. There it was, flying next to the city flag and the Canadian flag. There was another flag that he thought was some sort of British flag. I felt I had to tell him it was the Ontario Provincial flag. He went on to say, what an experience it was that I could be there taking a picture of that flag, proudly flying next to all the others, only in Canada. In other countries it wouldn’t be celebrated in the same way.

This whole experience made me think back to 2011 Toronto Pride, I had taken a photo of the Pride flag with the Canadian flag (see below) that I was so proud to have taken. It was seen by a writer who wanted to use it in a story he wrote. It was an honour to have it included in a story about Pride.  I agreed to it right away. I have since donated a copy of it for a silent auction at a local fundraiser last year.

In a true “social media experience” I saw a link on my facebook that led me to another link for a site that one of my contacts was following called Fierté Canada Pride. Right away I noticed their profile photo, I clicked on it to see a larger version of it and sure enough, it was the same photo of the two flags. I thought about other photographers I’ve met who would be upset someone used their photos without permission or compensation.  For me, if it’s for an HIV cause or to promote Pride, then please use it. I volunteer to do all photos for my local AIDS Service Organizations for most of our events. It’s a way of giving back for a lot of what they have done for me. I sent the site a private message letting them know that it was my photo and that it looked great on their site and to enjoy it.

So giving in this way is a large reward for me. Karma, what you give out, you will get back. Beautiful!

The most positive Karma experience happened about a week and a half ago.  I was out taking pictures at the local University Arboretum. I had been there for an hour or so, just sitting at the picnic table trying to catch the birds flying in and away from the feeder. I noticed a few people coming through the area. I talked to a couple of them, just a hello.

Then I noticed a couple  of guys. They looked around, then sat down on a bench to the right of me. They were around my age. I had this feeling that maybe I knew them as they fit the general description of a couple of guys I once chummed around with. One was a friend I had hoped to reconnect with, someone I hadn’t seen in about 15 years. I had made a commitment at a recent retreat back in February to try to re-connect. I had found an old phone number, but misplaced it.

So, after about 10-15 minutes, I decided to pack up and go say hello, see if it was that old friend. I turned around to see they were on their way out of the area, so I had to hurry. I managed to catch up and I called out the friend’s name. He turned around and said, “pardon me?” I said his name again and he looked at me. Then he said, “don’t tell me, give me a minute”. It was him, and like me, a little older a little more grey. He lives in another nearby city; we hadn’t seen each other in maybe 15 years and there we were, in the least of all expected places. I go to this place so often. We tried to catch up but he was in a hurry to go somewhere, said he had an appointment, he gave me his cell number and I was to call him.

This has to be the most genuine form of Karma ever, or was it “fate”? Could they be the same thing?  To move forward now I realize that I will need to do some apologizing to him. I can’t go into the reason for the separation but I wasn’t the person I am today. I didn’t know or use empathy or compassion very well then, hell most times I can’t say I had any awareness of it. I am aware that it may not be the same friendship it was before, but it could be. We can’t get into the same trouble  - or can we?

I spend a lot of time on the internet, but I am trying to get out more. Now that the weather is cooperating it’s been easier. Photography has become a social affair; I get to meet other photographers or people asking what I’m taking pictures of and they share stories of their own. One gentleman and his wife last night suggested I join the seniors’ centre, they have a photography club and I could win the photo of the week. I do qualify, you need to be 55 and over, and I am over.

So I’m trying to put a finger on what it is I’m doing and I don’t see many great things. I think a lot of it is just staying positive, avoiding the negatives. If you want things to add up in life, avoid the negatives. I have seen how people treat me by the way I treat them, I do it all so differently now. I made many bad choices in my life and tasted the bad Karma on those occasions, so yes, the good Karma is working for me now.

So I’ll sign off here and since Pride season is kicking off around the world, Happy Pride everyone.

What can I possibly write about online hook up sex sites that hasn’t been said?

I’ve been off them for a couple of years since a guy I was seeing made me delete the last of the profiles I had, which was basically to stay in touch with a lot of guys I know in Europe.

The last straw for me came when this guy I was with looked at me and said, “Ya I took some GHB, didn’t I put any in your drink?” I’m no prude, but since I put “NO PNP” in my profile, and the fact I’ve O.D’d on this stuff before, I didn’t take kindly to the prospect of nonconsensual drug use.

Fortunately there was none in the drink, as I know all to well what it tastes like and its effects. It was the fact my choice could have been taken away from me that hurt.

For the last couple of years I’d rely on a couple of dwindling fuck buddies that I could call up. Slowly this was turning into a pretty sexless life.

My return to the avenue of online shopping was prompted by my trip to Tel Aviv. First the guys are super hot there; I had to meet a few. Secondly, I don’t go to bars to meet people anymore, and I don’t drink.

Feeling not that confident anymore, I snapped a webcam shot of myself thinking that at least if they message me it will be the most recent photo I can have. To my surprise, I learned that being “fresh meat” in Tel Aviv, even being me, means there’s a lot of demand. I think over the month I got about 70 messages. I was shocked!

The problem in Tel Aviv is that everyone has their heads buried very deeply in their asses about HIV. Despite there being over 7,000 positive guys in the area, when I disclose I’m treated like I’m the first poz person they’ve ever encountered. I get the questions. I tell them, there are 7,000 guys here who are positive, you’ve fucked many of them, don’t treat me like I’m the first.

Suddenly there is a concern about doing this or doing that, even though they are happy to do this or do that with those who don’t disclose. This different environment that I’m used to took me back a bit. I had to decide what was the best way to do this.

It wasn’t like I have having sports sex on the hour.  I didn’t mention it at fiirst until we were talking face to face. It’s not my favourite way, but at least if someone is going to be an asshole, they can do it to my face instead of just ignoring a message I’ve sent.

Coming back to Canada I decided to create a couple of profiles. I’ve always thought there is something odd about gay Torontonians, and going back online really confirmed it.

Suddenly, (fresh-meat syndrome excluded) on the first site, there was no interest at all. Something happened to me over the course of flying those 6,000 miles back home. This site is exactly the same as it was several years ago - stale with the same 60 to 70 odd guys parked waiting for someone to message them.

The second one is marginally better as I will log on and see a few messages. In each I’ve said I’m positive at the end of my written portion.

I don’t like the sites that force me into disclosing. I usually do anyway, but I’d like that choice. It feels like I’m being outed to be avoided.  I like to have the choice on how I disclose such issues.

The lay of the land has changed quite a bit. I highly suspect the D&D free people are negative looking to bareback “safely.” So in essence we have many barebacking sites even if we don’t call them that.

There is a bit of dishonesty there, as they go out of their way to exclude, but can’t say it’s because of barebacking.

One guy I met off of this site, during our email exchange asked about my status. He’s very young, in his twenties. I wrote him back and expected to hear nothing back. Instead I received a nice reply saying we could still play “safely.”

What I didn’t realize is our two-tiered sex reservation system. Namely, the best sex (first class) is without condoms, flying economy, you use condoms; both of these will get you to your destination, just one is more desirable. So the HIV status question can be more about determining what kind of sex is available. But it's hard to know what are someone's motives. 

Perhaps with Israeli HIV-stigma fresh in my mind, I began to feel like an outsider looking in and much more so than I had ever in the past.

As per a friend’s recommendation I went on a barebacking site. I never ever contemplated such sites before in my life.  To my surprise I got 30 messages in a week. 

Even with people condemning such an act, I did it and was surprised to see that I was no longer on the inside looking out. This is a very low stigma site. I don’t use condoms with other positive guys anyway, so what the hell.

The irony is that the sites that I once scorned and judged are the very ones that I find the most affirming. Really who wants to be at a party where nobody wants you, which is how Manhunt & Gaydar etc. begin to feel like.

I’ve now successfully turned around my sexless life, one of my goals I can cross off of my "to do" list post-Tel Aviv. 

This article was originally published in TheBody.com here

An undetectable viral load: the point at which HIV, though still present, cannot be found in a person's blood with the most sensitive tests available. It's a powerful concept with profound implications to the life of a person living with HIV (and his or her partner). However, according to CDC's treatment cascade, for a host of complex reasons, 75 percent of people living with HIV in the U.S. have not reached the point of viral suppression. (Among some specific groups in the U.S., that number is even larger.) For many of those that have, reaching that point was a major milestone in their lives. We asked people living with HIV to contribute thoughts and stories about getting their own viral loads to undetectable.

Minister Rob Newells, Oakland, Calif.; Diagnosed in 2005

Reaching undetectable never seemed like a significant milestone to me. I waited for my CD4-cell count to drop below 400 (about 18 months after my initial diagnosis) before I made the decision to begin antiretroviral therapy. My viral load, which was never extremely high, has been undetectable on every test since I started HIV meds in 2006.

For a long time, I thought viral suppression was a normal result of taking the medications. I expected nothing less. The HIV treatment cascade was a visual wake-up call that I am in the 25 percent minority. Clearly, we have much more work to do to increase retention in care and adherence to the medications that both improve the health of people living with HIV/AIDS and help to prevent transmission of the virus.

Meta Smith, Baton Rouge, La.; Diagnosed in 2001

At the time I was told I was HIV positive, I was placed on meds and did not have any idea how being undetectable would help me. When I had been on the meds for at least three months I returned to the doctor after lab work and was told I was undetectable. I knew I was feeling better after the meds; but after being told what undetectable was and how it would affect my life, I need to say I was on TOP OF THE WORLD and have stayed that way since then. It meant the world to me and changed my life, for the better. I got busy living.

Nelson Vergel, Houston, Texas; Diagnosed in 1986

I'm on the last combination I can try. I take a lot of pills. ... There's a part of me that's been very frustrated, extremely frustrated, with the fact that I've had it really hard when it comes to HIV. I've never had an undetectable viral load until three years ago ... Twenty-six years with virus in my blood, no matter what I did, no matter how many conferences I went to, no matter how many papers I read ... I felt like a loser, like a failure -- really, they call us "failure patients."

Watch Nelson's full "Day in the Life" video.

Bernadette Berzoza, Denver, Colo.; Diagnosed in 1989 

Over the past few years I have really fought and struggled to get my viral load down. It's been 23 years that I have been positive, and in the beginning it was just keeping your T cells up. Then the viral load was added. I was so freaked out when they told me my viral load was in the millions and we needed to change my meds to get it to undetectable. I did what was recommended but it wasn't working for me as they thought it would.

Read Bernadette's full story of getting her viral load down after many years.

Joe Ohmer, Bronx, N.Y.; Diagnosed in 2002

Eight months after I was diagnosed with HIV, my gastroenterologist that was taking care of my liver issues did some blood work, and my HIV viral load was undetectable without any medication. I didn't realize that that was anything significant or insignificant at the time, until maybe eight or 10 years later when my GI doctor mentioned it to me. I went on a regimen of Epivir (lamivudine -- also used to treat HIV, in different combinations with a higher dose) and Hepsera (adefovir) for my hepatitis B, which since I've been on it has been undetectable as well. Except for one blip, my HIV viral load has been undetectable.

Recently, my GI doctor, who's the same one who saw me initially, brought up that I was undetectable before I went on any regimen.

Read the rest of Joe's unusual story of being undetectable without medication.

Melissa Baker, Mechanicsville, Va.; Diagnosed in 2007

I was diagnosed August 2007. By January 2009, I made the count-dependent decision to start meds. It took me longer than three months to become undetectable. If it had taken me any longer my provider was going to change my regimen, fearing a possible resistance. The day I heard "undetectable" finally came before he had to, and my virus has remained undetectable since. :) I was ELATED!

Reggie Smith, Atlanta, Ga.; Diagnosed in 1984

After being sick in 2005, I have been taking the antiretroviral combination that has kept my virus at undetectable levels, and allowed me to enjoy really good health. With God's grace, and enough desire to live well, I have been able to adhere pretty well to this regimen. My oldest granddaughter was 2 years old at the time. Now she is 9, and I have two other granddaughters, a grandson, and a set of boy/girl twins! I play softball and golf, take flying lessons, I am of service to my community, and I am blessed to share my experience and hope with you.

Read Reggie's full story of coping with being tired of taking HIV meds.

Lillibeth G., New York City; Diagnosed in 1992

When I was told my viral load was undetectable I felt 100 pounds lighter. My greatest challenge was getting to an undetectable status. I had multidrug resistance so getting to undetectable was a milestone.

I was diagnosed in 1992 and it was difficult for me to adhere to my treatment since I was in denial and angry at myself (I should've been more selective of my partner). During one of my doctor visits he found a clinical trial I was able to join for both Isentress (raltegravir) and Intelence (etravirine). I was determined to bring my viral load to undetectable since I have so much to live for; I needed to live for my son, my mom (she was alive at the moment), myself most of all; I have things to do, people to educate. After a 17-year fight, I got the GOOD news: "I'm undetectable!" It makes me feel so alive.

I have a whole new look at life: I'm going to live; I have a fighting chance. Now I can talk to others about the importance of getting to that point -- it gives you hope. I'm always smiling and laughing; life is so different for me now -- I have HOPE.

Pastor Andrena Ingram, Philadelphia, Pa.; Diagnosed in 1989

THAT was another day, I remember with clarity. Waking up and dreading my doctor's appointment, because I knew I was going to get my blood-work results, and because I was about sick and tired of injecting myself. I was tired of Fuzeon (infuvirtide, T-20), I was tired of medication, I was just tired of it all.

I sat down in her office, and she pulled out my chart and looked at the labs, and smiled. I was like ... OK, what is my CD4? And it had been explained to me months before that they were beginning to look at this thing called "the viral load" ... and how that was more important than the CD4 count. She told me what my CD4 count was, which had peaked a bit ... but she was still smiling. And then she said: Guess what Andrena? Your viral load is under 50 copies! She was cheesin'! Grinning from ear to ear! I still didn't understand what that meant, until she stopped grinning long enough to tell me. That it meant that the virus in my body was undetectable …

Even though she explained it to me, I still didn't quite get it, until a few days later ... my mind had to process it. It meant that the Fuzeon was working. It meant that I was NOT gonna die (anytime soon). ....

I was ecstatic!

Read Pastor Ingram's full story of getting to undetectable.

Shannon Southall, Denver, Colo.; Diagnosed in 1992

February 1996, four years after being given my HIV diagnosis, I found myself lying in a hospital bed, and hearing that I now have AIDS. My CD4 count was 131. I needed to add more medication. When I was initially diagnosed in 1992, I had 896 CD4 and my first doctor put me on AZT monotherapy. After a friend found an infectious disease specialist I was switched to Zerit and Epivir.

Now lying in the hospital my doctor came in and said there was this new drug available called Crixivan and he strongly recommended that I add this to my current regime. My viral load was 159,000 and these new meds show that they can reduce the virus in my system, therefore prolonging my life. So of course I said yes. By August, my viral load was undetectable, less than 200, and my CD4 count was finally up over 200. ...

A few years ago I started to wonder about switching or stopping meds for a while. Then I met the man who would become my husband. He is HIV negative and I know that keeping my viral load down is crucial to maintaining a healthy sex life and reducing the risk of transmission to him.

Read Shannon's full story of 21 years on HIV meds.

I hadn't talked to my cousin David in close to fifteen years.  This phone call was a flashback to when we were both living in Manhattan in the 1980’s and our frequent dinners eating cheap Chinese, talking non-stop and laughing with our mouths full of food. 

We had an unusual way of deciding who would pay for dinner. He was a commercial photographer and we'd meet at his studio in Manhattan’s Photography District, near the famous Flatiron Building.  

We’d hang out on a corner of Broadway for five minutes and have a contest. Whoever spotted the most cars filled with Hasidic Jews heading downtown to Brooklyn would get a free meal.  No doubt this sounds odd if you don’t know Manhattan, but there are lots of Hasidim especially in that part of the city and because of their close-knit community – both at work and back home – cars filled with bearded men in black hats were not quite but almost as common as taxicabs. 

On the phone we spoke for nearly an hour, catching up on the last fifteen years. Work, his kids, my writing, our parents, the old days, the recession - and then he asked about my health and I told him how good it was.  

"Do you know how lucky you are," he said, repeating it twice. I readily agreed, knowing that he too had many other friends who died hard deaths. We acknowledged the unfathomable randomness of life.  We discussed my great fortune and other friends, those who had it all only to be struck dead, without warning – Jake while windsurfing, Stan a vicious type of brain tumor, others from car wrecks, kidney disease and other maladies.  

I don’t always feel lucky so the reminder was a gift, one that I’ll take as I head back to New York for my 30^th college reunion in June.   

I’m excited to go. I’m looking forward to it, but wish I had more on my resume. Among the friends I’m excited to see for the first time in decades are a U.S. Congressman, a lawyer who is one of the leading activists in the fight for marriage equality, successful artists and professors too.  

And me, a writer who spends too much time not writing, with declining freelance revenues that have led me to anxiously scour Craigslist looking for more catering work, gladly serving and bartending even though I’m making the same hourly wage I made when I catered between jobs in the late 1990's.  

Swiss Chard Beggar’s Purse, Maam? 

I like the work if not the pay, but passing kobe beef sliders, swiss chard beggar's purses or pouring cocktails isn’t a bad way to make things happen. I’m proud of my resilience, my ability to put things together to pay the rent even while I am occasionally embarrassed by seeing people I know who are surprised to see me holding a tray of champagne at a wedding reception.   

After all I’m the guy who drove a taxicab in New York City after graduating from college with honours. The guy who never worried much about earning money for the future, a creative sort, who didn’t fit in the box.  

Sometimes I can’t sleep and lie awake worrying about everything from the NY Mets bullpen to what will happen when I’m too old to work. I wish I’d done things differently, made more money and saved it, bought a house, wore suits to work, could take vacations every year. Was my lack of concern about money because my upper middle class upbringing left me deluded that things always work out or because I thought I’d be dead before I reached 40? 

Would whoever threw up in my bed clean it up? 

A month ago I lost my black necktie, the one I need for catering and was enraged at my carelessness. It would cost me another $7.99 at Ross Dress for Less to get a new one; that’s half an hour’s pay. I berated myself for the stupidity. My fury got worse. The only one Ross had in stock cost $16.99, $18.48 with tax. Determined not to spend that much I spent two hours scouring half a dozen thrift shops looking for a bargain before I returned to buy it.  I found the missing tie the following week.   

I frequently joke that I have my retirement plan almost in order. It has four parts, and three are taken care of. The three pieces in order are a hot plate, a space heater and an inflatable aero-bed. The only thing missing is a friend with a garage I can live in that has an electrical outlet that can support all three appliances without blowing a fuse. I'll be the old guy sweeping the sidewalk in front of their Victorian, whom the neighbors bring leftovers too and kindly listen to my stories about the old days, before getting away relieved. 

In college, early in my freshman year, I earned the nickname "Ralph". If you don’t know the slang, to ralph is to vomit. By October I had twice thrown up and blacked out.  When I was told I was the one who puked in the shower I thought it wasn't true because the guys in the dorm figured I was wimpy and would clean it up without much debate. The second time I woke up on a Saturday morning smelling of vomit, furious about the fact that someone threw up in my bed. 

When my roommate said it was me I didn't believe him.  After all I wasn’t a big drinker, had never listened to Neil Young before college and wasn't a sloppy drunk. 

Of course I was the culprit.  But lucky for me, my stomach couldn’t handle too much booze and despite the roster of world-class drunks on both sides of my gene pool I was spared the family affliction of alcoholism.  

Though spared the fate of becoming a drunk, the nickname lasted all four years of college. There were people who thought that was my name, including Fran, one of the nicest of the sweet ladies who worked in the dining hall. 

On graduation day she was beaming as she gave me a hug. 

“Ralph you were one of the nicest kids I ever met.  I hope life treats you well.” 

It has. Even if I’m passing trays of champagne and sleeping on an inflatable mattress in someone’s garage when I'm old it has treated me very, very well.  

Oh yeah and if you need to borrow a black necktie, let me know.  I’ve got an extra.