This article first appeared on the blog Socially Fit.

Meet Daniel Uy. A yogi by trade and fun-loving guy by nature. Very funny and honest. There is one thing that makes him stand out (other than his awesome personality), and that is the fact that he is HIV+. He has been living with the virus for fifteen years. Through yoga, fitness, and overall well-being he has reclaimed his life and here he is sharing his story.

I wasn’t an adult very long before HIV.  I was never the modicum of vitality.  I ate a lot and was extremely nervous.  I was going out to gay bars for the first time and had only recently began to drink and smoke.  It was a confusing, awkward, and uncomfortable time with a mouth as big as an ocean and an ego to match. Also with the frailties of one who feels unworthy.  Know what it’s like to be with someone who is afraid everyone is better than him so he tries so hard to put you down to lift themself up?  Yeah, I was that guy.  I was fun at parties, but only under the influence.

Once I found out that I was HIV+, it was a relief! I had been thinking about killing myself from a very young age and into my teens. It was good to know I had an end date and it was hopefully going to be soon.  I also remember watching my family doctor, that I’d been with since I was a teenager, who was the one who broke the news to me, cry in front of me.  He also said words that I have never forgotten “It doesn’t matter how this happened, we are just going to take care of it”. I am truly blessed to have surrounded myself with non-judgemental people in my life.  It was a mixed response.  He told me, “we’ll take care of it” and at the same time I was happy to know I might be dead soon. That should let you know where I was at that point in my life.

I really felt included when I began yoga. I have never been the model of physical health.  I was a fat kid growing up and actually did manage to lose a bunch of weight when I came out of the closet at 20 years old (going from 260-220 lbs). The only time I have ever been thin was when I was on the descent towards having full-blown AIDS at 27 and weighing in at 145 lbs. I felt safe in a yoga studio and in the practice room.  The postures themselves were not that difficult and you didn’t have to do them for long.  I started in hot yoga so you sweat, A LOT!  I remember standing in tree pose with my hands in prayer and sweat dripping down each elbow and looking at myself in the mirror and thinking “God!  I’m such an athlete!!”

The funny thing is I have just never really considered yoga to be a workout.  It was a spiritual journey and I had a lot of questions!  Somehow that made it easier to do.  Since it’s easy to do, maybe I could do it too and it grew from there. Postures evolved, sequences and poses have ballooned to include things that I think are beyond my human abilities but still in my mind, it doesn’t count as hard or impossible, just something in this journey I may not have figured out quite yet.  I really hope from now until the day I leave this plane of existence, there are still many postures that were on that list I was “working” towards.

Although it was the physical that brought me onto the mat, it was, in itself not enough to keep me there.  I started to “wake up”.  I became aware of things, and in the beginning, some of these revelations were so overwhelming that I couldn’t process them.

There was a family gathering about 4-5 months after I started yoga and there was an argument at the table. As it was happening I became incredibly aware of my breath. It was like it got louder in my head and the fight in front of me got quieter.  It was the first time that I can remember where I was calm in a heated discussion.  It felt like I had superpowers or something.  I wanted to know more about that.

Being HIV+ means that the veil and illusion that life will last forever is gone.  No fairy tales.  No make-believe world.  This sh*t is real!  Where I am today is where I am today.  It may not be like this ever again.  It could be gone, it could get better or worse. I am an optimist and most may not see this as optimistic, but there is an incredible beauty in that.

Right now I am the strongest and most fit that I have ever been in my entire existence in this physical shell.  There was a time when I was so weak and frail I could not stand or walk ten feet without fainting.  All we have is this one breath.  Right here.  Right now.  Inhale.  Exhale.  And being here right now, in this moment, is the best place that one can be.  Other problems and worries fade away when one stays grounded in this moment.  Close your eyes and take a full breath, in and out right now and savour it.  I can wait.

I would like to think that I am in a place now where I can make a positive impact on the HIV community at large.  I have never considered myself an activist.  I am more of a lazivist!  Up until last year, I had never “officially” stood out publicly as being HIV+.  Everyone in my family knew, friends knew, employers and co-workers knew, but never my students or the average person.  I remember when I was writing my bio for my website, www.danieluy.com, and I was sitting with the “how did I get into yoga” question and couldn’t avoid the HIV thing.  I remember going should I or shouldn’t I when it came to disclosing.  This was my question I was sitting with one week where I had made the decision that on Friday I would choose and that would be that.  That very week I met not one, but two other yoga teachers that are HIV+ and both fairly new in their diagnosis.  Hearing their stories it became quite apparent that the only question I was asking myself was “How could I not disclose it?”  This became much less about facing my fears and much more about helping to alleviate theirs.  If and when I ever question or doubt myself, I think of them and others right now suffering in silence.

It was also around this time that I happened to meet Brian Finch, Founder of PositiveLite.com, Canada’s Online HIV Magazine.  Since I had already been writing some things for my own website, I thought perhaps maybe I could share some information to others like myself.  I mentioned that I don’t know how professional I’d be.  It’s been ages since I’ve worked in a 9-5 business setting, but they wanted my voice and style as is. Since August 2011, I’ve had articles posted, about twice a month.  I have really come to love them.  Through that I have been able to make new connections within the HIV community and help, one on one, some guys and gals on this journey.  

A friend of mine reminded me a few months ago, people need to see that there is someone who has been going through this serious medical thing for 15 years, yet can still remain healthy and physically capable alongside some of the city’s best teachers despite it.  I had never thought of that before.  Sometimes it’s great to have someone on the outside remind me of what I really do.  My favourite quote is from Ghandi, “My life is my message.”  It’s that simple.  If you want to see what I’m passionate about and believe in, watch me and you’ll see it.

I could probably do more.  If anyone has suggestions, please feel free to e-mail me! Recently I was speaking with a friend about the idea of trying to incorporate yoga fundamentals into a workshop style practice/meditation for people in the AIDS Community and AIDS Service Organizations (ASO’s for short).  I haven’t figured it all out completely but I really see it as being something that would have me travelling to different areas and communities as well as helping my brothers and sisters tap into something that I have been able to reach as well.

I think I have been fortunate to have been spared much of the insanity of the misconceptions and fears of others.  It’s either that or I have an incredibly short-term memory so I don’t recall much anymore.  It’s getting close to half my life living with HIV, so I forget.  Sometimes it’s hard to distinguish between what is HIV and what is simply growing old.

I would be naive to say that the fears do not exist.  I have a friend that said they’re ok with me having it, but then later I learned that if they ever went on a date with someone who was, they wouldn’t see them again.  That hurts.  Because I know what that kind of rejection feels like.  It’s like you’re a leper – untouchable and unlovable.  And it can sting.  On the flip side, if the situation was reversed, I may possibly act in the same manner.  We’ll never really know.  One thing I do know is that if someone is on HIV meds and their Viral Load is undetectable, and sexual protection is used, the chances of passing it onto someone else are quite small. There’s a debate right now in the Supreme Court of Canada on Disclosure discussing this topic in great lengths.

As I mentioned, being who I am, and the size that I am, it has been quite rare that I have ever had to deal with overt judgement or discrimination based on my HIV status.  Having said that, there is one place I taught (I’m no longer there anymore by my own choice on a different matter) that had a meeting and seriously discussed firing me because I had mentioned I was HIV+ and they didn’t feel I would be capable as a hot yoga teacher.  It turned out I was the most popular teacher in that space until my departure. With the proper medication and lifestyle, the average life expectancy right now for someone who is HIV+ is now 75 years.  HIV- people’s life expectancy is 82.  We are not that different at all. 

Right now, I am currently starting each day reminding myself of the word “Enough”.  That I am enough and that there is enough.  I sometimes allow my fears to drive me into doing and saying things I normally wouldn’t because of not being good enough, having enough, making enough, or being strong enough.  Today, right now, I am enough and I have enough, period.

As for my future, I would like to get married.  Maybe write some more, perhaps a novel or series of short stories.  Physically, I want to get Ashtanga Vinyasa Primary Series nailed down and be on the Secondary Series by the end of 2012.  There I said it.  I hope my teachers read that because I’m going to need help!  I want to own a home in the city and hopefully get to a place in my career which allows me more freedom to practice and play in my other pursuits.  I would love to spend more time fire-spinning, learning to cook, learning to dance, or tea drink my afternoons away with good friends around me.  

Strength is something much more than a physical measurement.  It comes from someplace inside.  It fuels you even when your body is spent and everyone around you says you cannot go on and you are done.  Strength is not fighting and destroying everything you come up against.  Strength is standing unarmed in front of an army moving tanks and declaring that they cannot and will not go any further.  What are you willing to stand for?

Left - Cover picture for John’s portfolio of writings about performing in The Laramie Project – Ten Years Later, a play written by Moises Kaufman and members of the Tectonic Theatre Project.

We’re now at the end, but it’s only another beginning

This incredible theatrical masterpiece has drawn to an end here, but only with respect to the performances that had been scheduled.  Both Wednesday and Friday nights performances achieved standing ovations. 

Thursday’s matinee unfortunately had some audience members pulled from attending.  This performance in particular was set aside for GSA (gay/straight alliance) students and their teachers, but I guess their concern was the dialogue was not suitable for students to hear.  In my mind this has proven not only to show a lack of trust from members of our community, but also sheer disrespect to this young man’s legacy.  All of us as a society should never deny others from experiencing a record pf historical events, especially those which have changed our laws. 

I’m taking the liberty, having portrayed Matthew’s father in this production, to say to the world “Yes, my son was and would have been an inspiring and wonderful extension to our human race” had he only been given the chance.

I want to thank each and every one of you who have taken the time to read my personal thoughts on this story. I’ve only wanted to shed a little light on such a horrible event that took place in our history. 

Bye for now………………..The Dreamer

This article by Roger Pebody first  appeared on aidsmap. 

The First Study

Pre-exposure prophylaxis (PrEP) would be an acceptable HIV prevention strategy for large numbers of gay, bisexual and other men who have sex with men in major UK cities, according to two studies presented to the British HIV Association (BHIVA) conference in Birmingham this week.

The conference also heard details of a small pilot PrEP study, likely to start recruiting later this year.

A cross-sectional survey of 842 HIV-negative gay and bisexual men, recruited at bars, clubs and saunas in London, suggested that half the respondents would be interested in taking PrEP.

Respondents were given information about pre-exposure prophylaxis and asked: “If PrEP were available, how likely is it that you would take a pill (oral dose) on a daily basis to prevent HIV infection?”.

Half said yes, with 16% saying they were likely to take PrEP and 34% saying they were very likely to. Men interested in PrEP were slightly more likely to be under the age of 35 (AOR adjusted odds ratio 1.58), have attended a sexual health clinic in the past year (AOR 1.59) and to have previously taken post-exposure prophylaxis (PEP) (AOR 1.96). After statistical adjustment, various measures of risky sex were no longer associated with interest in PrEP.

In this survey, 17 men (2.1% of those answering the question) said that they had previously taken antiretroviral drugs to reduce their risk of HIV infection.

Secondly, clinicians at the Manchester Centre for Sexual Health surveyed HIV-negative men attending their service who reported unprotected receptive anal intercourse. Of the 121 men who responded, 36% said they would be “very willing” to take PrEP while only 14% said they would not take the treatment. Daily dosing was perceived as a better option by four fifths of respondents – just one fifth would prefer taking a dose before sexual activity.

These data confirm and reinforce findings from a study reported in November 2011, which found that half the gay men surveyed would consider taking PrEP. Once again, daily dosing was preferred to taking a dose before sex. In the qualitative data, men commented that sex is often spontaneous and that they felt daily dosing would facilitate adherence.

However these data are all based on giving men a few key facts about PrEP and presenting it as a hypothetical option. In real-life circumstances, where men think more seriously about PrEP as an option and hear friends’ experience of taking it, actual uptake and sustainability may be very different.

While the Manchester respondents largely assured the researchers that they would take all their doses of PrEP and wouldn’t have more risky sex, real-life experience needs to be tested in research.

To this end, the Medical Research Council are seeking funding for a 5000-participant, two-year study which would randomise HIV-negative gay men who report unprotected anal intercourse to either take PrEP (Truvada) and attend motivational interviewing (intervention group) or to be put on a one-year waiting list for PrEP and to have motivational interviewing in the meantime (control group).

For the researchers, it is crucial that this is an open label but randomised study, in which participants know whether they are receiving the actual drug. This unusual research design would, they argue, tell us more about the real-world effectiveness of PrEP than a blinded study as it would take into account the possible impact of participants taking more sexual risks because they felt that PrEP afforded some protection. (Researchers call this ‘risk compensation’ or ‘behavioural disinhibition’).

Rather than test efficacy in artificial conditions, the study would therefore test effectiveness in more realistic UK conditions.

So far, however, the potential funders of this costly study have not been persuaded by this argument and it is unclear whether the study will be able to go ahead.

What will, however, start recruiting later this year is a pilot version of the same study, aiming to include 500 men who attend one of around twelve sexual health clinics.

As well as allowing the researchers to have a dry run of the main trial and identify teething problems with its strategy, it should also provide valuable information on the number of men who actually follow through on a clinician’s offer of PrEP. Data on the characteristics of men who seek PrEP, drop-out rates and risk compensation will also be collected.

The researchers intend to take some of these data back to the main study’s potential funders, in order to support a revised application.

Acceptability of taking HIV treatment for prevention purposes

As well as asking people hypothetical questions about PrEP, researchers have also been asking people waiting for an HIV test result hypothetical questions about treatment as prevention.

Individuals from high-risk groups attending the Jefferiss Wing at St Mary’s Hospital for HIV testing were given an explanatory paragraph about treatment, infectiousness and safer sex. They were then asked: “If you were diagnosed with HIV would you consider taking treatment to reduce the risk of passing on infection (even if you did not need to take treatment for your own health)?”.

Four out of five respondents said ‘yes’. Encouragingly, gay men who reported unprotected anal intercourse in the past three months were more likely than others to be interested in the idea. Less encouragingly, people who had had a sexually transmitted infection or who had previously taken PEP were slightly less likely to say that they would take treatment for prevention.

The researchers suggested that the latter factor may be associated with PEP users’ experience of side-effects. It contrasts with the findings of the London PrEP attitudes study described above which found people who had previously taken PEP more likely to be interested in PrEP.

References

Aghaizu A et al. Who would use PrEP? Predictors of use among MSM in London. 18th Annual Conference of the British HIV Association, Birmingham, abstract O23, 2012. See abstract here.  

Thng C et al. Acceptability of HIV pre-exposure prophylaxis (PrEP) and associated risk compensation in men who have sex with men (MSM) accessing GU services. 18th Annual Conference of the British HIV Association, Birmingham, abstract P233, 2012. See abstract here.

Jones C et al. Treatment as prevention: the views of high risk patients attending an outpatient GUM clinic. 18th Annual Conference of the British HIV Association, Birmingham, abstract P234, 2012. See abstract here.

This article is copyright © NAM Publications, 2012. All rights reserved

You know that thing that ardent ornithologists do? You know, writing down their sightings of each different variety of bird they have laid eyes on, where and when. This post is not about that. It's not about looking, and it's not about birds.

No, when I was a fresh-faced young gay, just out of the closet, I briefly kept a little list of the men I had slept with. No euphemisms: I had had sex with them, usually with very little sleeping involved. My WASPy prudishness caught up with me a few months in and I stopped with the list after a few entries where I didn't have names, but only situations or the make and model of the car that picked me up… Who am I kidding?! It was probably only the colour of the car, which pretty much exhausts my knowledge of cars! 

Even with this abrupt end and the short experience of my list, I was already up to about fifty entries when I stopped. Such a shame I didn't keep it up, as it might have been a very interesting sociological artifact by now. This came to mind in a conversation recently, as I also discussed filling out an online "How gay are you?" quiz with a friend. My friend got to the question about how many different men he had had sex with and he said, "There were only three spaces, so I put 999." I, much more modestly, put 500 at the time.

Now are you seeing how my list might have been interesting to revisit after a lifetime of encounters? 

You might actually be wondering aloud why I should be so proud of being such a slut, whore, whatever, and thinking smugly that you now know why I turned out HIV-positive. I have two answers to share on that topic. First, it isn't that I'm necessarily proud; it's that I refuse to be ashamed. Second, as I frequently assert in meetings with public health types in the context of my work, it really doesn't matter how many partners you have, it matters what you do with them. So clearly, I am on the sex positive side of this debate. 

The other thing that I feel the need to express is about the source and timing of my HIV infection. I don't know, and I have a smidgen — but not really more — of intellectual curiosity about the answers to those questions. They do not preoccupy me. 

I am a gay man who started having sex before we knew about HIV. This is not in any way to suggest that I was or wasn't infected before we knew, or that that would really matter. I was as human afterward as anyone who might be infected today. We aren't machines making cold rational decisions based on available data, we are humans who sometimes don't think about what they are doing or just need some human contact at the moment, or don't always make decisions about our pleasure based on fear of risks. 

When we found out about HIV with my sex life already underway, there was some adaptation around the equipment or the acts, but not around the attitude. I think that changed for those coming of age and coming out post-HIV, at least until recently, which only makes it more of a shame that I didn't maintain my life list. 

I could have written my autobiography as a thesis.

Recently I found myself having to end an on again off again long distance connection.  Two years was a long time to remain uncertain, but we did try and it really was a more off than on situation.  Still such a time can leave feelings raw and emotions high.  I was sorry for my own indecisiveness and even more so to inflict that on another on an ongoing basis. 

Over the past seven years I have been an importer, if you will, of boyfriends and paramours from the GTA (Greater Toronto Area)  and beyond.  I don’t want to imply that the fair city of London does not offer up their own share of eligible bachelors … I’m sure they do, but for me importing importants and impromptus insured a certain distance that I felt necessary for both my own comfort as well as my denial. 

There is also the whole serosorting aspect of my thought process with regard to dating that quite honestly has me shopping in the big city in part because I see the stigma less then I do in my own backyard.  When you add that mind set, and for me it is the mind set that makes me most comfortable when dating, the fields narrow … but I digress.  I am talking in the more general sense with regard to long distance relationships. 

With the recent change in my personal life I spent the better part of Easter weekend spring cleaning and rearranging my home, my thoughts, and in some ways my life.  Part way through the extra long weekend I spent the Saturday evening with friends for a fabulously festive feast.  Two of the gents attending that evening had also recently embarked on a long distance connection and the coming together of friends and food were in part to celebrate the recent union of men and minds. 

Sadly, all good things must come to pass … distance being a factor. 

Are relationships that start from afar doomed to fail?  I pondered this thought throughout a sleepless night of late and I decided that yes; they are doomed! 

I can’t speak of course for my friends but I do mourn what I would have thought a good match of these two unique and wondrous worlds.  I can only bring my own thoughts to bear on the subject of love from afar.   

Relationships for me, when they start, are so often this explosion of feelings and dreams,and I statements … “I want to see you, I want to be with you, I want to hold you”.  When we are mere blocks away we can savour and soak up this blooming love fest; but when there is travel and waits and schedules we so often have to quell those initial thoughts with the mundane act of planning spontaneity. I can still recall asking a florist if roses and cheesecake will last for 2 hours in the back seat of a black car on a summer day as I navigated my way to the big city and my latest beau; she suggested keeping the air on.

Add to the initial distance aspect the weather, mode of transportation, and last minute changes and we then need to rethink the simple act of planning dinner and a movie.  Successful long distance relationships, I have come to believe, begin with two who live with or near one another. Then distance doesn’t become a factor.  Most I would think are more relaxed about a loved one who is far, but not far, for long.  To start off a relationship with needing to “understand” when all one wants to do is enjoy and share and simply snuggle is the beginning of a downward trajectory…this is at least what I have found to be true for me. 

That is not to say that if some handsome, passionate, compassionate, semi sane suitor from who-knows-where calls and asks me out that I would say no … but that’s a whole other story.