Persons with AIDS’s lives changed in March of 1996 with the introduction of what is referred to as “the cocktail.” I remember my lover Chris and I having a conversation about the future over lunch one day in 1990. We both were positive with AIDS diagnoses but were both healthy. Chris had a cultivated devil may care attitude about life in general which was one of the things I found attractive about him. I, on the other hand am more grounded and have a tendency to plan and save. Chris was chiding me for this propensity, “You know Woody, we will both be dead in five years and what good will all that money do you then?” Well, perhaps he was planning on being dead in five years, but I certainly wasn’t!, and I told him so. Chris died in October of 1995. Had Chris lived to see the introduction of the new “cocktail therapy” of non-nucleoside protease inhibitors would he be alive today? That is a question no one can answer. It is a question that certainly entered my mind many times when I started my new therapy in 1996.
Not only have most PWA’s lives changed but so seemingly has the face of AIDS itself. AIDS seems to have become a “manageable” disease. People are living longer. The sense of hopelessness and terror has been removed. No longer is the obituary pages of the Bay Area Reporter growing bigger and bigger with each passing week. It is so easy to slip into seeing the years following the introduction of cocktail therapy as “post-AIDS.” The fact is, people are still dying. The new drugs do not work for everyone. They do have catastrophic long term side effects.
AIDS has changed so many aspects of our lives and our culture it is really difficult to grasp the enormity of it all. It has made us more sex phobic, it has pushed us into a new conservatism masquerading as liberalism, and it has caused us to confuse the right to self-determination with misinformation. I am holding in my hands a pamphlet produced by the City and County of San Francisco’s Department of Public Health called “Reading This Might Save Your Ass.” It is the language of “straight talk” using code phrases such as “save your ass” and headings such as “Fucking, Sucking, Rimming, and Making Your Dick Work For You.” Under the heading of fucking I read, “Fucking with out a condom is the easiest way to spread HIV. Play it smart. Hopefully the people you have sex with will be honest and will know their HIV status . . . but they might not know or they might not want to tell you.” “The easiest way” belies the very concept of “straight talk.” What all of this “straight talk” doesn’t say is AIDS kills. What all of this straight talk avoids saying is Fucking without a condom is unsafe, if your partner is infected you will be too, if you are infected you will infect your partner and there is no cure. AIDS kills. Fucking without a condom these days is inexcusable. It is murder.
And now we seem to be getting the message that serosorting is okay. It seems the message of use a condom every time didn’t work for everyone, or some of us have become burned out on it. And we have the cocktail now. Well, if the message didn’t work, don’t soften the message, change it. A young man I know who, when I first met him, was expounding on how the message of AIDS, the very name AIDS, was too sex-negative. “It’s time to forget AIDS,” he told me. “It’s time to re-name it, call it something else, because it is not the same as it was in your day.” Well, six months later he came to me and told me he had seroconverted. Now that is a tragedy. That should not be happening today. Suggesting serosorting as a possible safe(r) sex strategy for positive men runs the risk of re-infection with a different strain of HIV and the possible mutation of a super-strain, for negative men of course the risk of one partner not knowing their current status or of lying is always going to be present. It just seems too risky and stupid to be a strategy which should be receiving any endorsement from the HIV, Inc. and public health communities. There is still no cure. AIDS still kills.
Chris finally did learn how to save. After four or five bouts with pneumonia for which his Kaiser Hospital health plan refused to admit him to the hospital -- take these antibiotics and make an appointment to see your doctor in three weeks, they would tell him and I would drive him home and carry him up the stairs to his apartment as he was too weak to walk -- his sister and I finally had to place him into a hospice. One October morning my phone rang. It was the hospice calling to say that Chris was non-responsive and I should come over as I was designated his agent to make health care decisions. Apparently Chris had been diagnosed with cytomegalovirus and was going blind. Rather then tell me he decided to save his sleeping pills until he had enough to take his life. The nurse told me that usually they don’t resuscitate at the hospice, a fact I already knew, but since Chris had had a hand in this they would pump his stomach if I wished. This was what Chris wished now though. I sat with him for the next ninety minutes, holding his hand, stroking his head, reassuring him that everything was okay and that he should just let go. I know he heard me. I know he knew I was there. I could tell by the way he responded to my words, my touch. He finally died as I sat next to him, holding him.
This is what we have forgotten. Scenes like this still happen today, just not as frequently. We must not forget this still happens. AIDS has not changed. It still kills. There is still no cure.