This article from This Positive Life by Warren Tong first appeared on TheBody.com here.

How did you find your HIV physician?

The vaccine program that I've been talking about at Vanderbilt, they're really connected with Nashville CARES. As a small business owner, I'd really supported all the events that the organization does every year; I've always been involved in that. I didn't ever think that I'd be a client.

I went over there, and they gave me a list of people; and then I just called around. And I found a doctor. It's been amazing. I think that the physician is kind, is warm, and is also very knowledgeable.

Little things: They said that there's more studies going on about just the neuroscience kind of stuff that goes on with your brain right after you get HIV. I remember during that amount of time, through January and half of February, that there were times I couldn't even remember conversations that I just had. And so there was a short-term memory kind of loss. My physician was able to talk to me about that. Because that's an area where more research is being done. She's always traveling to these conferences, and that sort of thing.

It's been awesome. I have a fantastic doctor! She's understanding, patient, informative, motivating and the best choice for me for treatment. At one of the visits -- you know, when I got to 550 -- I was really aching to discuss treatment. Based on the current numbers, I have made the personal decision not to begin medication -- however, I am also involved in a couple clinical trials that allow me to have access monthly to my viral load and CD4 numbers. Based on this participation and the volume of real-time numbers, I am comfortable making the decision to choose a path that is right for me.

But my hope is that they come out with like a once-a-week kind of pill at some point, because I'm absolutely terrible, even about taking a multivitamin every day. So I've been trying to do better. My physician has given me an exercise, to try to take a multivitamin every day at the same time. She's trying to prep me for when I have to start taking meds. But I'm just hoping that the longer that we wait, as long as my health is OK, or stable, that something new will come out.

How do you think you'll deal with adherence, once you do start treatment?

One thing that I have been real honest about, with all my physicians, is that I am a drinker. I like to have drinks when I go out a couple times a week. I've always been nervous that if I'm supposed to take a pill at 11 and I'm out till 3, whether I'm going to remember when I get home, or when that has to happen. I know there's tons of different little options, and different ways to do it.

But it's just going to be a commitment, once I'm at a position where I need to take medication. I've always been like that. I've never wanted to take any kind of medicine unless I just absolutely had to. But once I'm at that point that I'm going to have to, then it's just going to be a change of priorities. Then I'm just going to make it happen. So I'll probably use every one of those tools.

What do you do to keep healthy?

I eat healthy. I was smoking a pack of cigarettes a day. I've really cut back those. I'm not like a Nazi about it, where I won't ever have a cigarette. I'll have one if I'm out with somebody. But that was really an important discussion with my physician -- that I needed to quit smoking. So that was something that I did. And we discussed openly about me and my drinking. Then they were looking at my blood, and my liver, and making sure everything with that is fine.  

Also, knowing when to say no. If I'm tired -- and there were times that, within that six-month period, I was just kind of tired, and worn out from life. Before I was infected, I would just keep going and keep going. I wouldn't really take care of myself in that way. Now I've really learned how to say no. So if I can't do something, or if I just don't feel like it, for whatever reason, then it's a no.

I know everyone says exercising is important. But I'm not someone that is ever going to go to a gym; it's just always awkward for me to go to a gym. So I'll run. Or it's little things. Like, I live on the fifth floor of my condo, and so I don't take the elevator. I do the stairs.

I don't know if that answers your question. But there's no magic thing, I guess. That's what I'm doing. And I feel good. So . . .

That's good. Little tips here and there always help.

Well, I also think that a lot of what I've gone through is mental, you know? I decided how I was going to attack this disease. I decided how I was going to tell people. And I did it on my terms. Little things used to really bother me. I'm one of those people where everything can bother me. But since January 2012 I just don't let that stuff bother me, you know? If I can't change it then I can't worry about it. So I think that's part of it, too.

I've stayed really connected with things that really encourage me. I love Steve Jobs, so I was reading his book and his quotes. Getting involved with other people online through social media, just talking to them or checking up on them, and that sort of thing -- kind of investing, virtually through the Internet, in some other people's lives, to just check up on them and see how they're doing. It kind of took the focus a little bit off me and made it more about, you know, this is a crusade for everyone that is going through this.

A large part of the reason why I feel I'm doing OK is the way that I just decided to think about things and be positive. I've always laughed when everybody says, "Stay positive," because I'm always, like "Well, I am positive." But now I just said it!

Let's talk about your work. What kind of work do you do?

I'm a talent agent. I own a talent agency in Nashville. I deal with actors and hosts, children and their parents, for television, film, commercials, music videos, print jobs, that kind of thing.

How did you become involved in HIV? You mentioned doing prevention work before your diagnosis. How did you become involved in HIV activism?

Someone doing outreach about the HIV vaccine program approached me at an event at a bar. I really wanted to do it. Before that, there was a well-known female impersonator in town that passed away, and her name was Bianca. Mark Middleton was his name, and the personality was Bianca.

But she was HIV-positive and she was very, very vocal about prevention and the disease. When she passed away, I got my company involved with her memorial. Doing that really got me connected with people that were very sincere and honest and hardworking, when it came to activism and awareness. That's kind of how it started.

And then at one of those events, I saw information about the vaccine study. They said that they needed HIV-negative people that had sex with guys. And in my way, I was thinking, oh, this is so fantastic. This is my way to give back. So I got involved with the study.

From there I started doing some outreaches with them, looking for other volunteers. But I'm actually really glad that I got involved with the vaccine. I want to say this, because some people may wonder: With the HIV vaccine being studied, obviously, it's not a live virus. There's zero chance to get HIV from the vaccine. The way that I got HIV, even though I was in the vaccine study, was because I was exposed to it.

But once I got involved with that, and then Nashville CARES, and helping them raise funds and that sort of thing, I really fell in love with it. Whether people think that it's God or another power or whatever, I really think that it was orchestrated at the right time. Because I really got passionate about it at the same time that it happened to me.

I'd thought I was invincible. Other people have told me that, specifically: "Josh, we never thought this would happen to you. If it can happen to you, then it can happen to me." And that's kind of been their attitude -- which was surprising at first. But when I sat back and thought about it, it's absolutely true. I felt invincible. And so all of that year that I was involved in prevention and activism and that kind of stuff, it really prepared me to be able to tell my story and, now, raise money.

The last couple months I've been involved with some amazing fundraising people. And I'm proud. We've raised a lot of money in the past couple months for Nashville CARES.

Do you ever get sick of thinking or talking about HIV, or do you think you will?

I think I did. I went through a month in the beginning, to be honest, where every week I was doing something related to HIV or awareness or a doctor's office or something. And so in May of last year I kind of got a little tired. And so I just kind of stepped back a little bit. I didn't post any blog, and kind of stayed off Twitter, and even my Facebook.

Now, looking back at that, it was fine for me. It was a little selfish, I guess. What I'm doing is -- and what we're talking about, all of us -- is so much bigger than any individual person or any of our individual stories. We've just got to keep going and keep talking about it. Because the more we talk about it, the easier it becomes to be talked about.

What do you think are the biggest issues that need fixing in HIV today?

One, I think that HIV is not a "one disease fits all." I think there are regional things to think about. I think that people that live out West, in San Francisco, potentially deal with different issues than someone with HIV in Tennessee. I think that that needs to be approached.

After the pastor wrote me that unpleasant email, it really started making me think, why in the South are we having an epidemic, but we also have the highest number of churches? So there's a tremendous opportunity that is being missed in churches with a captive crowd, if you say, to talk about HIV or STDs [sexually transmitted diseases], or any of that. Some churches are against contraceptives or prevention, I guess. My church that I grew up in wasn't. They were OK with birth control and condoms. But they never talked about sex or disease, or any of that.

And so I think the first thing is to look regionally, maybe, at potential issues. And that's what I've been kind of looking at. I can't speak for anyone else in the country, except, you know, Nashville, or the South, really. Here, the stigma is very strong, still. And I was nervous about that.  

Because we're not talking about it enough, in my opinion, in the South -- HIV and prevention and even early on in schools, besides mixed in with every other STD that you can get -- what I think that it's doing is that it's making it harder to talk about later. When I was growing up, I don't really ever remember talking about HIV or STDs, beyond the one day in health class.

And the way to combat stigma: I was sitting in a group therapy, right after I was infected. Maybe I was a little bit green, and maybe the gentlemen that were in there who have had HIV for years, maybe they were a little bit jaded. But in that group therapy that I was in we talked about stigma. And they kept bringing up stigma, that it's so terrible and hard.

And then I just asked a simple question, but it really was a little bit of an epiphany to me before I released my blog. They said the stigma was so bad. And so my follow-up was, well, what have you guys done to combat it? What have you done to fix it? And almost everyone in the room said that they hadn't told anyone that they had HIV. Again, understand some people -- maybe a majority of people -- can't disclose it. I get it. With me, I could.

What was just an epiphany to me: The only way to attack stigma is to talk about HIV, and to talk about it in its face, and show that it's OK. And so those two things, the regional thing and really just keep on talking about HIV, because by doing that, it will become a little more accepted -- not accepted that you want to get it, or that it's OK that people have HIV, but that it's not a death sentence, and that we're not the scum of the earth because we have HIV.

Could you compare how you felt about having HIV when you were first diagnosed, as opposed to now? How has it changed?

I think it has changed. Right after I found out, I was very scared of what people would think. I knew that it wasn't a death sentence and that I would get on the medicine and that though my life expectancy may be shorter than if I was negative, that I would live a long, great life. But I was scared about if someone would love me, and I was scared about what people would say about me.

Right after that, I made a decision that if someone wouldn't love me romantically because of that, that I was OK with that. And I really meant that. I would rather talk about it, about this disease, and attack the stigma, than worry if someone is going to love me, or want to be with me the rest of my life. Because I will be fine.

But coming now, several months later, I respect and I understand the disease a lot more. So my attitude toward that has changed. The thoughts that have started going through my mind now are, you know, disclosure. Why is disclosing or not a criminal act? My mind has just started going down that road. It's not something that I'm going to focus on, but it's just starting to get into the sub-issues; after you get over the big issue of having HIV, it's just how to live with it, you know? Knowing when or not to disclose, or why people choose not to.

But I'm not scared for my life like I was right after I found out that I was positive.

How do you think having HIV has changed you?

It has made relationships that I have with people, in general, more important. It's humbled me tremendously. I mean, I was a cocky bastard. Last year and before that, I was a talent agent and was cocky, and cared less about people and more about myself. This disease really humbled me. I couldn't think of anything worse than contracting HIV, before I contracted it. That was the worst thing in my mind that could happen to me, as a gay man. And then when it happened, it was very humbling.

It was humbling to know that I had to reach out to people to help me, that I needed to go to a therapist and that I needed some of those services that Nashville CARES has provided, that I have supported for years but never thought I would use. So it was humbling, in that aspect.

The other thing is that -- and I don't know if you've heard this before, or what -- but after I found out that I was HIV positive, it made my life a lot richer. Things that don't matter do not matter. Little things don't make me go crazy like they used to. Relationships mean the world to me. My family: It got me even closer to them. So in a weird way it kind of refocused my life into being better.

It's really hard to explain and put that to words, but my life is totally different, in the way that I look at people and relationships; and how I even look at myself is a lot different. I mean, it took a while for me to really be OK with looking at myself in the mirror right after I found out that I was positive. I'm OK with that now. And I feel good about myself. 

What advice would you give to someone else who has just found out they are positive?

If they just found out that they're positive: One, that they are the exact same person they were the hour, the day, the year before they found out that they were positive. That they are still them. Now they just have something that is going to make them choose relationships more carefully and, really, how things are going to be valued.

The one suggestion that I would give is find at least one person that you feel that you can trust, and tell them. Don't try to do this by yourself. Whether it's a therapist, or somebody that truly loves you in this moment. Try to find at least one person to tell that you're positive.

Get online, create an anonymous Twitter account, and find other people like me that are able to talk about it, that you can communicate with, and that it's safe. If you email me anonymously then I'm going to respond. And I won't know who you are but you at least start that chat.

Read TheBody.com. Gosh, I've spent hours on the website. Learn as much as you can about HIV.

But the main thing is that you're still you and that the way that you think about yourself is as important as getting treatment for the disease.

Do you have any closing thoughts, or any takeaway messages you want to relay?

Yeah. First, thank you so much for asking me to just chat with you. Everyone knows their own personal story of the moment they found out that they were positive; and maybe they even have stories like mine, where they know the person that infected them, or that exposed them.

But what you guys are doing is simply amazing. And I know that the three weeks when I was not sure if I was positive or not, I did more research than I'd ever done about HIV. And it's websites like you guys' that I came to, and that I learned the information. And I heard other stories, and I was reading about people. And so, thank you. You know? You helped me tons.

That makes me feel very proud. Thank you for the kind words!

Find Josh Robbins on Social Media

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Check out Josh's blog at imstilljosh.com!

Remember that time you went to that awesome restaurant, ordered a fantastic meal, everyone enjoyed it, then you realised at the end you didn’t have the money for to pay for it?  No? 

OK, how about that great drive up the coast you always wanted to do? The people you met, the things you saw, everything was awesome – but you ran out of petrol three-quarters of the way there. Had that happen?

These are metaphors, of course.  I like using them, as well as satire, which often leaves readers dazed, confused, and thinking I’m a wanker.  I also stray off the point from time to time.

So here it is:

This will be the last Bipolar Bear blog entry. I don’t know if I will start up again at this stage. Some of my reasons will be clear by better explanation of the metaphors above.

Firstly, my grandmother is dying. This is the second close family member to go in under a year and, as I alluded to yesterday, it’s time to focus on the things that matter.

Second, there isn’t enough of me to go around. Much as I get a great deal out of writing and interacting with you all through this medium, I’m starting to get tired – literally. I often sleep through entire weekends. Other things, besides family, are demanding my attention in a way I can no longer ignore.

This blog began as a part of my work at the Mental Health Foundation in New Zealand. Indeed it was publicly supported as such. A year later, there was debate within the organisation as to whether a blog dedicated to gay men’s mental health and wellbeing fitted with the Foundation’s work.  Similar debates were had around the project that was to become my documentary, “Men Like Us”.

I left the organisation and funded the completion of “Men Like Us” personally – this is nothing new to me, all but one of my films have been paid for out of my own pocket.  The result was better than I could have imagined – apart from the high-profile and excellent blockbuster doco “Untouchable Girls” – it’s the only gay-themed documentary from New Zealand to ever be released in cinemas, and receive glowing reviews from critics and viewers alike. That’s a testament to the power of the nine men’s stories contained within it.

While I continue to believe there is immense social value in films by and about gay men, there is not a great deal of financial value in them in terms of profit.

The cost of completing “Men Like Us”, supporting it through a theatrical release in New Zealand and getting it onto television, and subsequently onto DVD and download are still being recouped.

I have also incurred considerable debt underwriting the productions made by my charitable film-making trust, Number 8 Films, which my co-trustee Andy Jalfon described in Express recently as coming to a natural end.

This is broadly true, in the sense that if you sprint non-stop for fifty kilometres, things will come to a natural end when you collapse on the pavement gasping for breath and needing to be defibrillated.

I’m really proud to have instigated monthly gay film nights in Auckland, which ran at a loss for several months until we convinced a couple of key sponsors to come on board – Get It On and the GABA Charitable Trust. This support was great, as the events could not have been run without it. Cinema hire, film hire and censorship is an expensive business for a niche audience, as anyone who runs a gay film festival will tell you.

The administration of these events, including negotiation with distributors, putting films through the New Zealand censorship process, writing promo copy for media, liaising with the cinema over ticketing and promotion, is time-consuming as well. I continued to do all of this until the film nights ended in February of this year, despite the fact I’ve been living in Australia since August.

So, to quote David Bowie’s fantastic comeback single, where are we now?

We are tired, and we are in debt. We meaning me. I need to recharge my energy and my finances. I need to focus on my family. I need to find new ways of working and expressing myself creatively after being worn down by more than a decade of being surrounded by “no” people; be it “no you can’t do that”, “no we won’t support that”, or “no I haven’t got time to help you”.

I’d like to thank each and every person out there that has enjoyed the writings, the films, the events, have been moved by them, shared them with friends, bought DVDs – all those forms of support which have made it worthwhile to keep going through the tougher periods.

But for now, it’s time to shut the door on the vault and say “game over”.

Then place people I don’t like in a series of elaborate traps in which they’re hacked into Findus lasagne pieces (just kidding).

I trust you will understand.

This article first appeared on Christopher’s own blog here.  

This article from This Positive Life by Warren Tong first appeared on TheBody.com here.

How do you start the conversation with somebody when you're disclosing to them?

Well, for me, it's actually been pretty easy. Because I don't know if I copped out. I mean, I posted it on Facebook, and I have a blog. The blog is now at almost 15,000 views. Then being on the cover of the magazine here, locally. Everyone here, as far as the gays in town, they're all aware. I guess some of them are probably tired of me talking about it.

But there's other things that I had to think about. I have a company and I have a staff, and we have interns and that sort of thing. And so I've made it a decision again -- it's not my legal responsibility -- but I made a decision that I was disclosing to everyone.

You know all the pink stuff, the marketing for breast cancer awareness? Susan G. Komen for the Cure? People walk around and they say stuff like, "I'm a survivor of cancer." Or, my mom -- I've done MS Walks with her. And it's very easy for her to tell people that she has MS. I see it real similar, that it's just a disease that I'm fighting. There's no cure yet, and there's no vaccine that works 100 percent yet. So I'm just on a journey, just like other people; but it just happens to be that what I'm fighting is HIV.

It is so important to me for people, and particularly -- and that's where my heart is -- ifor Nashville, because this is my home; I've lived here for 10 years. So it's so important for other people that have HIV that in any way feel like they're scared or feel less or whatever. I want them to know that they're still the same person, that they're OK, and it's going to be fine. So that is really the bottom line on all of it.

The benefit for me, with the way that I disclosed, and that I've told everyone and I've told them so quickly was that I haven't gone to the bar or to the club or whatever here, and knew that people were talking about me, about something that they haven't heard from me about. So I don't feel uncomfortable going out now. And I'm sure there are people that are going to say things. But I've tried to be honest and I've tried to be transparent.

And some people have called me brave, which I don't think at all. I don't think that what I'm doing, or what I've done and what I'll continue to do, is brave. But if it helps one person or two people here feel like they're OK, then that's enough.

A good example of that is I got a call, a couple of weeks after I released the blog, from someone -- and I couldn't even tell you who it is now -- but they called me. It was a 22-year-old here in my city that had just found out a couple days before they called me that they were HIV positive. And they contemplated committing suicide because of it. And they happened to see someone reposting my blog on Facebook and they read it. Then they felt compelled to call me.

From there, I talked to him for just a few minutes. And he said that because of the blog he decided to tell at least one of his friends, or a couple of his friends. So now he's fine, you know? He didn't commit suicide.

I don't think that I had anything to do with that, except that I know that's what people feel, or that's what people have told me that they have felt immediately. And so if my being able to talk openly about how I contracted it, and what I'm going through, and how I feel, and all those things, if that helps other people then it's worth it to me. Because I'm in a position where I can, you know? I have a strong support group around me. My family means the world to me, and they're OK.

I don't think you give yourself enough credit. It sounds like you saved that boy's life. Would you say that's the best response you've gotten from sharing your status?

It's funny, but I have been flooded with different stories of people. And so some of the best responses to me are people that have been living with this disease for 15 years or 20 years, and they come and say, "Thank you. I haven't been in a position where I could really talk about it like you, but thank you. It makes me feel a little bit more normal at least." Just as a whole, that's the stuff that feels good.

But there have also been a couple of bad things. I got a really nasty e-mail from a previous pastor. He told me everything that he thought about why I got the disease, and how I'm living with it, and all that stuff.

Then, you know, there's thedirty.com, which is a funny website. Somebody posted something not pretty about me on there, basically saying that I'm trying to get fame from this, or monetize this. And that's not the case at all. I haven't made any money from talking about my status, and I wouldn't.

But all that is to say that there's good and bad, but the great things have far outweighed any negative that could ever come at me.

What did your youth pastor say to you, and how did you react?

Basically what happened is that I released the blog, and then the pastor saw the blog and sent me a very long email, basically saying that it's unfortunate that I contracted the disease, that he saw the disease as a direct result of me living a sinful lifestyle from my sexuality, and that God really wants to love me, and so I need to repent and turn away from all of this stuff. Just a religious rant. But the hard part for the email was that it was really tied in with some things that were very personal to me that he really used as weapons -- the fact that I had been molested as a kid, and the fact that the pastor's oldest brother passed away from HIV, and that sort of thing.

He was trying to do exactly what he thought was right, which was to email me and tell me that I'm wrong and that I'm sinful. Although I disagree, adamantly, with every theology that he discusses in the email that he sent to me, I really truly believe that his heart was in a place where he thought he was doing the right thing. So I don't hate him or despise him, but I did respond to him via a blog.

I basically just told him that HIV was not a result of God being angry at me, and that eventually I would be in heaven and that I'm OK.

I did rebuke him a little bit, in a nice way. I told him that this was the absolutely wrong email to ever send to someone that's recently infected, and especially someone that's recently infected and then trying to talk about it in hopes of decreasing stigma and also furthering the discussion of prevention in others. This is totally the wrong tone. And so I responded in that way. But I haven't directly spoken or had a conversation at all with that pastor. And I don't really want to.

He sent me the email but I responded to him in the only way that I knew how at the moment, which was via my blog. But I did disguise his identity so hopefully he hasn't gotten any hate mail, or anything.

But, you know, it was totally the absolutely wrong thing to ever say to someone, particularly someone that's recently infected.

Let's talk a little bit about dating and relationships. Has being positive affected your dating life or your sex life at all?

During the three weeks that I was waiting on my results, that constantly came over my mind. I was absolutely scared that I would never be loved again. I felt that maybe that the gays in my town would think that I was used goods. I had already come out of the closet about sexuality, and that had limited the people that would want to date me. And then now that I'm HIV positive I was like, wow, that even makes the pool even smaller. Because I thought that only someone that was HIV positive would even want to date someone, you know, like me. I was real nervous about that.

The other thing that was really hard is that during the middle of finding out, I had met someone that I hadn't been intimate with, but I'd seen him out several times, and was really kind of digging this guy. And the thought of having to tell him that I was positive: I just knew that he would run away. So I was kind of preparing myself for that. 

I didn't actually call him and tell him that I was positive. We hadn't have sex or anything like that, and so I didn't have to tell him anything. But he is a friend of mine on a social media; and so when I released the blog on my Facebook, he saw it. And he actually called me and he said that he wanted to see me. And I said OK. We met, and he told me that it was OK.

I think the coolest thing that could ever happen for someone that is positive is if someone that is negative just wants to date them. I think that is the coolest thing, and one of the bravest things, in the middle of all this. With that said, of course dating and relationships and that kind of stuff is overwhelming. I mean, when do you disclose to someone? Do you get them to really start liking you before you tell them? Or do you tell them from the very beginning, when they have absolutely zero invested? I don't know. I think that's a question that keeps going. 

Obviously, I've researched and looked online. There are tons of people that only want to hook up with someone that is DDF (or disease-and-drug-free); they would never want to date somebody that was positive. I've seen stuff online, blogs and forums where people are saying that positive people should only date positive people so it will quit happening. That was something that I was really concerned about. It was a decision that I had to make, because I didn't know how he would react, or anyone else would react. But I decided I was OK with being alone the rest of my life if I could talk, if I could tell my story, and if I could in some way decrease the stigma and then further the discussion of prevention. That was more important. And so I had to be OK with that. But it worked out really well for me. So I'm dating somebody that I've been dating for over a year now.

We've already established that on top of that, you also have a very close and supportive family. Did your relationships with them change at all after you disclosed to them?

The only thing that changed was that the first several weeks after I told them that I was positive, they wore me out with phone calls and text messages, asking how I was and how I was feeling, and that sort of thing. So it was appreciated, but I finally had to tell my family: "Listen, you don't always call me every day anyway. So you still be you, and I'm still me. We can talk; but you don't need to ask me every day how I'm feeling, and if things are OK. Because I'm fine." But besides that -- which is, obviously, appreciated -- my family really rose to the occasion and have been amazing supporters for me.

That's wonderful. Can you tell me a little bit about your background? Where did you grow up?

I grew up in West Tennessee, in a small town called Jackson. It's between Memphis and Nashville. A lot of people know Jackson for one reason, really: My hometown has gotten hit by tornadoes a lot.

It's a very small conservative town. I never hooked up or anything in my hometown; that would have been way too weird and that sort of thing.

When did you tell your family that you were gay?

I moved to New York right after high school, to go to an acting school. That was the first time that I had voluntarily had sex with a guy -- a terrible experience, by the way -- then I moved back.

I kind of dated a couple people after I moved to Nashville for college. I first told my sister, when I was around 24, that I was gay. And she was fine with it. I hadn't told my mom and stepdad, or my stepmom or my dad, yet.

So I went home one Christmas the year after I told my sister. My mom, again, has MS. We were in the bathroom, and she was getting ready or something. She asked me, "Are you dating anyone? Because I never hear you talk about anyone." And I kind of smiled, and I said, "Yes."

And she said, "OK. Well, do you want to tell me about it?" I started telling her about it. But it was very generic; but still, to me, it was obvious that it was about a guy. So I thought I had come out to my mom.

So she would call me for the next six months, and we would talk about the person that I was dating. But I didn't realize: Because of her medicine she was on, she didn't remember that conversation, and she didn't realize that I'd come out to her. And so for six months, we had talked on the phone and she would ask about whoever I was dating. But it would always be, you know, "How is your friend So-and-So?" And so I just assumed she just wanted to call him friend, which was fine. But she really thought it was a friend.

There was a day that I realized absolutely that it wasn't clear to her that I was gay. And so I had to come out to my mom a second time, which is funny.

How I came out to my dad is, I had called my stepmom. I told her. And I told her to tell Dad. An hour later he called me and asked me if I needed to tell him anything. And I said, "Nope. You probably know everything."

He said, in his Southern way -- he's a fisherman; he's a tire salesman -- the nicest thing that he could say was: "You could kill someone and I'd still welcome you into my house." Which makes other people laugh; but that's totally my dad's character. So I knew it would be OK.

But since that time my sister has come to visit; I've taken her out to the gay bars and she obviously has met who I was dating and that sort of thing. My dad and my stepmom: I convinced him to let me take them to a drag show, and to the gay bar. And they know who I'm dating, and who I've dated. My mom is the same way. It's awesome, because it's completely open.

The one thing that's cool now is that my mom sent me a text the other day saying Obama is backing gay marriage. And I was, like, "Yeah. That's really cool."

And she said, "Yeah."

And so I sent her a text message -- something like, "So, are you ready to walk your son down the aisle one day?"

And she replied back: "Absolutely." Which was just a cool text to see from my family. But, yeah. I'm completely out of the closet about my sexuality and, I guess, my status.

When did you know you were gay, yourself? And was that difficult?

It's always a funny question to think through. I remember when I was a kid, and I don't know the age -- 5 seems to be the right one to say -- but I remember playing with the neighbors, the little boy next door; I remember kissing him. And that obviously is not what other kids do.

But also, we lived in a small town. I had girlfriends, and I really liked them. But it wasn't ever where I wanted to go home and sleep with them, or anything. You know, we were just friends, I guess.

What I explained earlier about when I was younger and was molested: That was when I was older. I was, like, 10, or 11, or 12, or something like that. It was a family member. But as far as knowing I was attracted to guys, it was early on. I remember kissing that boy.

Do you want to talk about the molestation at all?

I'm really OK with it now. It was a situation where it was a family member and I was told that this is what guys do, you know, when they're older. And so when I say molested, there wasn't ever anything violent or anything like that. But I absolutely was taken advantage of as a young person. And that should not ever happen by an adult, obviously.

But in the same instance, although I've kind of blocked those circumstances a little bit, the fact was, moving forward, that I don't think that that had any influence on me being attracted to guys.

Do you know what happened to that family member?

No. I told my family and my sister, and then there was a kind of division that happened in the family because of that. Years after -- I think I was 18 when I finally told them what had happened -- there was a lot of anger. I talked everybody down. I said, "I'm really the only one that has the right to be mad, and I'm not mad. I'm fine. And that's that."

The thing is -- I don't want to give too much information -- that some families have uncles that aren't legal yet. So they may be 10 years older, or something. But it wasn't like a fully grown adult.

There was nothing else that needed to happen. I'm completely fine with it. I've forgiven him. I mean, I'm not going to go to dinner with him, probably. I don't go to extended family reunions, anyway.

Let's talk about health care and treatment. What has your health been like since your diagnosis?

January was a total wash for me. I was completely sick, and not feeling great. I finally saw a doctor on Valentine's Day. The reason why my viral load was so high at the beginning, readers may or may not know, is because I found out so soon. It's been remarkable -- and those are the words that physicians have used -- being able to really track my process and my progress, particularly because of the vaccine study. They've had my blood work and have been viewing everything when I was negative, through seroconversion, all the way through now being four or five months into being infected.

It's been interesting. I've had; every two weeks or so, I've had CD4 counts and viral loads, which is way more information that I would ever suggest anyone ever have. But that's just the way that it's worked out between doctor visits or vaccine visits. My viral load came down, and it's come down even more.

I have made the decision right now, in consultation with my HIV specialist, to not begin medication, as my viral load (at last test) was 1,102 and my CD4 count is 730, with great percentages.  

It's important to understand that although I am not on medication, that I consider myself in therapy and in treatment. This discussion of being "on" therapy and "on" treatment leaves out a very attentive, concerned and responsible group of individuals -- like myself -- that, at the given moment, are not taking HIV meds.

Deciding which medication, if any, that I will choose at the exact moment that I feel is best for me, personally, is just that: a personal medication decision I will make based on my body and health, consultation with my doctor, and the current information and research that appears to apply to me. I'm not a one-type-fits-everyone kinda guy. But just because I'm not on medication, doesn't mean I am not taking this as seriously as others.

To be continued . . . 

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This article by Roger Pebody  first appeared on aidsmap.com here.  

The majority of American gay men in relationships say they establish a ‘sexual agreement’ with their partner, both to minimise HIV risks and to maintain the quality of their relationship, according to research published online ahead of print by the Journal of Sex Research last month.

However, partners do not always agree on whether they have an agreement, on whether it was explicitly discussed, or on what sex is allowed with other people. And the agreement had been broken by one or both partners in just under half the couples studied.

The study has also found that around a quarter of the HIV-negative men who have casual sex attempt to 'serosort' or use 'strategic positioning' when doing so. However, regular HIV testing was far from universal in this group, making such practices potentially unreliable.

“From a public health perspective, we need to encourage gay couples to have more honest and explicit discussions when establishing and honouring sexual agreements,” commented Dr Jason Mitchell of the University of Michigan, who conducted the research. “Sexual agreements are not only advantageous from a prevention standpoint for couples, but the agreement can also help strengthen their relationship.”

A sexual agreement is made between two individuals, and concerns what sexual behaviour may occur within and outside their relationship. Some agreements may simply clarify that sex is not permitted with other people. Other agreements may concern the relationship being ‘open’ to a lesser or greater extent. Many couples use agreements, in part, to limit their risk of HIV infection.

A couples study

Jason Mitchell’s study recruited both partners in couples and compared their responses, rather than relying on just one partner’s perspective. Men were recruited to this cross-sectional online survey via adverts on Facebook in 2011 – the advertising was targeted to reach individuals whose profile information indicated that they might be a man in a relationship with a man. The first participants provided the email address of their partners, who were then contacted and asked to complete the survey.

The study recruited 722 men (361 couples). This was a predominantly white (77%) and relatively well-educated sample, with a mean age of 33, all living in the United States. Couples had been together for an average of an average of five years; three-quarters were living together.

One in eight men had been diagnosed with HIV. Half of them were in a relationship with another man with HIV, and half with an HIV-negative man (i.e. in a 'serodifferent' or ‘serodiscordant’ relationship).

Most men reported that they were HIV negative. (Just 3% of the sample reported that they did not know their HIV status.) However, one in five of the ‘HIV-negative’ men had not tested since the beginning of their relationship, and on average, HIV-negative men had last taken an HIV test two years ago. There was considerable diversity in the men’s HIV testing practices, with a minority testing much more frequently than others.

On average, men said that they had discussed their HIV status 12 days into the relationship, and this occurred before the couple started having unprotected sex (a mean of 81 days into the relationship). However, when the couple made a sexual agreement, this typically occurred much later – 174 days into the relationship. 

Agreements

Although seven in ten men reported having a sexual agreement, this perspective was not always shared by the man’s partner. In 57% of couples both men agreed that they had a sexual agreement, but in 25% of couples, one man thought there was an agreement, while his partner said that there wasn’t.

Amongst those couples who agreed that they had agreed, 58% said that there had been an explicit discussion, while 11% reported that their understanding was more implied or assumed. In a further 31% of cases, one partner had thought they had had an explicit discussion, while his partner thought that it was implicit.

For 56% of men who thought they had an agreement, it was that the relationship was monogamous.

For a further 41%, the agreement was to permit sex with casual partners, but with some rules or guidelines. For the last 3%, there was an open relationship, without any conditions.

Responses detailing what was permitted for those with open relationship guidelines showed that around a quarter actually permitted unprotected anal sex with casual partners. While the data shows that some couples had different rules for receptive and insertive sex, and for withdrawal before ejaculation, respondents were not asked whether there were conditions based on the partner’s HIV status and seroadaptive behaviours.

Far more couples allowed oral sex and masturbation.

Open relationship guidelines were not just about the risk of infections, but also about intimacy and context. Having sex with a casual partner on more than one occasion, physically sleeping together and dating were all permitted by half or less of couples, whereas threesomes or group sex were allowed by 81%.

Men’s motivations for making agreements were not just about minimising the risk of HIV or sexually transmitted infections, although this was the most common primary reason, cited by 23%. Other important reasons included wanting monogamy or exclusivity; fulfilling sexual desires; establishing guidelines so as to manage expectations; and building and maintaining trust.

Jason Mitchell did not analyse motivations by type of agreement, but in a separate study, another group of researchers previously found that the themes of trust, honesty and strengthening the relationship were predominant in the motivations both of men with open agreements and men with monogamy agreements.

Breaking agreements

Looking at couples, including those with an agreement to monogamy, in 46% of cases, either one or both partners had broken the rules at some point during the relationship.

But in the previous three months, 80% of couples had stuck to their rules. In 15% of the couples, one partner had broken the agreement, and in 5% both partners had.

The main reasons for breaking agreements were sexual frustration and the ‘heat of the moment’. Only a minority of men (30%) told their partner that they had broken the agreement. Reasons given for not disclosing included not giving the partner a reason not to trust the respondent and fearing that this could lead to the relationship ending.

Risk reduction strategies

In a separate article, published in AIDS & Behavior in December, Jason Mitchell has also reported on the risk-reduction strategies employed by this group of men, both inside and outside of their primary relationships.

He was interested in strategies such as serosorting, strategic positioning, 100% condom use and taking undetectable viral load into account.

This analysis is especially interesting because Mitchell actually asked respondents whether they had used strategies to reduce their risk of HIV or sexually transmitted infections. In contrast, most other studies on this topic have examined the pattern of men’s sexual practices with partners of different HIV statuses, and attempted to infer whether there was a strategy in place or not.

It therefore hasn’t been clear from previous research whether the conscious and deliberate use of strategies such as strategic positioning is something widely practiced by gay men, or just a minority pursuit.

For this couple-based analysis, those couples in which both partners had diagnosed HIV were excluded. Participants were asked about strategies used in the last previous three months – they could name more than one strategy, either because strategies were combined, or because different strategies were used in different situations.  

Always using condoms for anal sex, or always doing so with an HIV-positive partner, was reported by a minority of men. Within the main relationship, 15% of HIV-negative couples (i.e. in which both partners thought they were negative) always used condoms, rising to 38% of serodifferent couples (i.e. in which one partner had HIV and the other did not).

When having sex outside the relationship, 38% of men always used a condom for anal sex.

Only having oral sex and never anal sex was reported, for the main relationship, by 23% of HIV-negative couples and 31% of serodifferent couples. This strategy was more commonly reported for sex with casual partners – by 51% of men.

'Serosorting' (having unprotected anal intercourse [UAI] with a partner because he was thought to have the same HIV status) was reported by 66% of HIV-negative couples. Moreover, this was also reported for sex with casual partners, by 27% of men.

‘Strategic positioning’ (only having UAI with the HIV-positive partner in the receptive role) was reported, for the main relationship, by 32% of serodifferent couples. During casual sex, it was also reported by 23% of men.

Having unprotected sex because the HIV-positive partner was either taking HIV treatment or had an undetectable viral load was reported by 24% of serodifferent couples.

It was much less commonly employed as a strategy with casual partners – by 1% of men in an HIV-negative couple and 14% of men in a serodifferent couple

Finally, it’s important to note that a significant proportion of men did not have a risk-reduction strategy at all, especially with their main partner. One of the answers men could choose was ‘‘regardless of HIV-status, we never use condoms and ejaculate inside’’.

For their primary relationship, 24% of HIV-negative couples and 22% of serodifferent couples chose this answer. It was also chosen by 9% of men having sex outside the relationship.

Overall, having unprotected sex within the main relationship (in the last three months) was reported by 87% of HIV-negative couples and 69% of serodifferent couples. Moreover, for 16% of couples, there had been unprotected sex both with the main partner and at least one casual partner during the same time frame.

Improving the quality of agreements

Clearly, with a number of couples permitting unprotected anal sex outside of the relationship and with a significant minority of men breaking agreements in one way or another, there are risks that HIV can be brought into relationships.

The research highlights a number of other limitations of some men’s sexual agreements, in terms of the frequency of HIV testing, the discrepancy in partners’ perceptions of whether there is an agreement and what it entails, and the quality of communication following breaks in an agreement.

This suggests that HIV-prevention interventions which support men in strengthening their relationships and in making better agreements would be warranted.

One such approach that is being piloted is couples voluntary counselling and testing, in which couples take an HIV test and receive the results together. The focus of the counselling is not on past sexual history, but on how the couple wish to manage the risk of HIV in the future. Quantitative and qualitative research suggests that this is an intervention that many men in relationships would be interested in.

References

Mitchell JW Characteristics and Allowed Behaviors of Gay Male Couples' Sexual Agreements. Journal of Sex Research, online ahead of print, 2013. (Abstract here)

Mitchell JW, Petroll AE Patterns of HIV and sexually transmitted infection testing among men who have sex with men couples in the United States. Sexually Transmitted Diseases 39: 871-876, 2012. (Abstract here)

Mitchell JW HIV-Negative and HIV-Discordant Gay Male Couples' Use of HIV Risk-Reduction Strategies: Differences by Partner Type and Couples' HIV-Status. AIDS & Behavior, online ahead of print, 2012. (Abstract here) 

Despite Mother Nature's reluctance to launch spring, fashionably speaking there are now plenty of options for at least looking the part. Retailers are now eagerly awaiting your patronage in selecting from the key looks that best suit your needs. And there are plenty of options to choose from.

This season it basically comes down to reflecting the person you truly want to be perceived as. Fear not, there is no need for deep introspection or psychoanalysis. By thoughtfully selecting the best key pieces and color options while keeping your own natural attributes, lifestyle and personality in mind your individuality and sense of style will naturally shine through. After all, this season's fundamental message is about rebirth and growth. Cheers to a season where you too can literally bloom and grow. Welcome to Spring 2013!

Your colour options range from chalky (read pastel) to vibrant shades. Various shades of red, yellow and blue figure prominently and can be teamed up or worn separately. For maximum results, keep the intensity of each colour in the same category. Utilize white, black, brown (especially camel) or navy to tone your looks down and amp up an understated edge of sophistication.

Introducing patterns and prints into your wardrobe is yet another way to add some punch to your look. Head to toe looks tend to be more playful and whimsical. A floral or sixties inspired printed top with your favorite jeans, chinos or walking shorts can suffice in creating a look that is on trend, tasteful and in keeping with wearing pieces that you wear as opposed to them wearing you. This concept can work wonders when reversed as well! Opt for flashy bottoms and solid coloured tops and PRESTO you have created a look that still works with your own comfort zone but creates a fresh approach to dressing for this season. Remember, you want your looks to represent or at least give an indication as to who you are. There are times we want to appear mysterious and there are those times we want to go for broke. This season allows us to run the gamut by playing with the wide range of colour options simply by experimenting with solids and prints and how we chose to team them up.

The typical trends (retro, sporty, romantic, androgynous and arty) now all have blurred and even overlapping boundary lines. Typecasting looks is becoming a thing of the past. Most designers have opted to explore the human condition thru modern day technology rather than attempting to make us a victim to it. Retro looks, for example, appear fresh and modern due to the influence of technology (both in construction and fabrication) that emphasize a certain demeanor rather than yet another weary trip down memory lane. Various prints  have been tweaked by digitally toying with their imagery to make retro looks more forward than simply nostalgic. Textiles have also been toyed with to create a new slant on tried and true looks that are a far cry from vintage hand-me-downs. This especially holds true in all fibers: from man made to natural.

Globally we are becoming more and more concerned about our future rather than our past and fashion is more in sync with this perspective than ever before. Old stereotypes are falling by the wayside as a result. Hence, trends may be a foundation merely to build upon as our desire to celebrate our differences rather than question them becomes more and more socially acceptable. There's also a healthy dose of humor tossed into this perspective which the warmer seasons tends to embrace more readily.

"Global fusion" in fashion takes various ethnic attributes from around the world and creates looks that manage to blend distinct styling attributes harmoniously making them appear less "costumey". Eastern and western influences now have morphed into wearable ensembles that are more and more difficult to pin point their origins. Designers once tapped into eastern influences in their efforts to create a larger demand in those countries for their labels. Ten years later, designers are now cleverly creating looks that appeal to a broader global market in their efforts to survive these turbulent and fiercely competitive times. One could look at fashion this season as yet another industry trying to strengthen its profitability by being more innovative and also, dare I say...practical.

There's also a "No Fuss" approach to dressing this season that taps into this mindset. A solid coloured polo shirt teamed up with a new looser fitting cuffed trouser could be an ensemble that will carry you thru the season in true ease. Add a pair of canvas shoes or sneakers in a patterned or solid colour and you have a great head to toe look that despite its simplicity still packs a punch. Untucked long sleeved shirts rolled up the arms to a flattering length can also create a look that keeps you from falling into fashion victim territory and again adds to your own sense of wearing what best suits you. These looks may appear simple but it's the cut and fabrication that really drives this "less is more" approach to dressing home.

Regardless of what style you chose to follow or dabble with, remember the over all message this season is about the end result of not just looking great but feeling great too. Spring maybe a little late this year but why wait to lift your spirits? Get into Spring and begin to feel and look blooming wonderful. Now might be a great time for Mother Nature to also . . "Jump start Spring"!