My Dinner With Alkies

Tonight and last weekend I was invited to an after Gay-A dinner with 8 or so other guys. That's about double the dinners out I've had in the last ten months. One of the common threads that seems to be shared by a lot of people in the program is that as the condition progresses, many of us start to drink at home, alone, more and more often. Maybe it's feelings of shame. Maybe it's a last attempt to exert a measure of control over something that ultimately controls you. Whatever the reasons, many fellow drunks had long past moved past the social component of drinking, and indeed, I'm far from the only one who found his social skills had atrophied from lack of use. Veterans from the program are acutely aware of this, and many make it a point to invite newbies like me out along with some groups. Before the events of the last two weeks, I would have been a nervous wreck. Worried about what to say and whether or not I was witty or interesting enough. Curiously, although mildly apprehensive, I jumped at the chance to join them, and found myself chattering away on a variety of subjects.

Continuing on Tom's Over-Indulgent Self Help Tour '07, earlier tonight I attended a support group for HIV+ men at the Community Center. Along with the usual suspects that show up almost every week, we had two new guys show up. One man, mid 40's and quite handsome, had tested positive only two weeks ago. The fact that he had already reached out to speak with a support group this quickly was quite remarkable. The other man was in his late 50's, and several months ago tested positive, only to find himself hospitalized two weeks later, whereupon he was given an AIDS diagnosis based on the fact that he had pneumonia and less than 70 T-Cells. A lively discussion ensued. Unfortunately, some of the HIV veterans with over 10+ years of dealing with HIV/AIDS behind them were occasionally less than sensitive in my book. They were a tad dismissive about HIV being no big deal, what with the new medicines available. Far different from when AZT was the only toxic poison as an option. And while that's true, there are still many issues surrounding a new HIV diagnosis for most, if not all, new infections that a certain amount of sympathy and sensitivity still should be used.

Some people are completely unprepared for the task of taking charge of their treatment. Making and then keeping doctor appointments. Having regular blood work done and then making sure you understand the results. Getting informed about treatment options and current recommendations, and then deciding what the right treatment for you will be and when. That of course leads to adherence issues. Some people, including one of the new men to the group, get completely focused on how they will likely have to stay on medication every day forever. They find that so distressing and "unfair" that they throw up their hands and stop taking meds. And of course, this can alter their treatment options.

Despite what you may have read or think you know, the social stigma associated with HIV is still alive and well, both within and outside of the gay community. HIV+ men often feel like the dirty little secret nobody wants to talk about any more. As if the guys who are (or think they are) negative would prefer us to just disappear. And of course there's that big elephant in the middle of the room called disclosure. Negative gay men (or those that believe they are) are not in the least bit prepared for how they are going to conduct themselves or address their status with other men, right up until the time they test positive. And then they spend months after diagnosis trying to figure out when to disclose, what to say, to whom and when. They have to prepare themselves for rejection, based solely on their HIV status. And they have to come to some moral, ethical and legal conclusion of what is sex, safe sex, risk and acceptable risk both for themselves and their sexual partners. It's a minefield we get to negotiate and no body's giving up a map.

So when there was an undercurrent, mostly directed at the woefully uninformed 57 yr. old, of "where you been?" and "Did you miss the last 20 years?" I found it insensitive at best. I also took exception to people telling the newly diagnosed 40's man how he should feel and what he should be focused on. You can't tell people how to run their disease or their treatment. All you can do is make sure they get good information to make the best informed decision for themselves. And then support them in that. You can listen, you can sympathize and you can try to keep them from falling in to despair or getting swamped with information and options they don't really need to consider right away.

So I managed to get the last word in at the end of the meeting (shocking, I know). I told the older members that I thought maybe they were forgetting that no matter what year it is and no matter what age you are, an HIV diagnosis, while unlikely to be a death sentence (in America), can still really rock your world. And it opens up a whole host of decisions and questions that take months if not a year or longer to answer. The point, as always, isn't what you did or didn't do to turn up HIV+. The point is you're one of us now. And I remember how, despite my excellent care and support from friends and co-workers, that first year was scary and exhausting. And I reminded the vets of that fact. And I turned to the newly diagnosed men and said I was sorry this had happened to them. That they would be fine, but that I acknowledge that testing positive sucks. And I offered to help with information and guidance and to provide expertize in whatever I can contribute. I got some grumbling agreement from the vets and a grateful thank you from the men.