It has been one month

[ATLThomas]

Questions/Concerns below my background: 
It has been a month and after the initial shock am really trying to adjust.  I know that I found out very quickly.  Negative at the end of November and tested positive at the beginning of March.  I worried after I was with someone I knew and trusted but he got very sick very quickly.  We were talking all through him running the fever, barely able to swallow blah blah blah .... I was working and his roommate was helping take care of him.  Needless to say about 3/4 weeks I was sick just like he was.  I went to the doc in a box, got antibiotics and was fine very quickly but once the antibiotics were finished I started getting sick again.  I went to my PCP and explained the situation and told him I was worried.  Long story short, I tested positive.  NEEDLESS to say, I am not blaming my friend as I don't believe he knew and it takes two people to do anything.

My doctor said my test results were pretty good and it was too early for me to start medicine.  I will have to go back after 3 months to be tested again and it will be time for my physical.  My results are:

Component              Your Value   Standard Range   
Absolute CD 4 Helper    728           359 - 1519
% CD 4 Pos. Lymph.    42.8            30.8 - 58.5
Absolute CD 8 (Supp)    704            109 - 897   
% CD 8 POS. LYMPH    41.4            12.0 - 35.5
CD4/CD8 Ratio           1.03             0.92 - 3.72   
WBC                           6.1             3.4 - 10.8   
RBC                          5.21             4.14 - 5.80   
viral load was 7090

I think the above should be ok for 3 months until tested again to see if I should start taking meds.

I am 44, single from my ex of 8 years for almost a year (still very close/one of my best friends) but am trying to deal with the following:

1.   I have only told a select few (my ex, my best friend and the guy I met about three weeks before I found out (we had always been safe but felt he needed to know).  I am afraid to tell my other close friends, more of fear of talking behind my back or treating me differently.
2.  Afraid I will be alone as I was I finally in the mindset of wanting to date again and hopefully meet someone to build a relationship with and honestly now I feel damaged.
3.  A feeling I did something wrong even when my intellectual mind tells me I did not. 
4.  A feeling of...if this was cancer or leukemia, you could tell everyone and have their support but HIV has a crappy stigma with a lot of people even gay people after all these years. (FYI - when its me its feels different, I dated a guy 16 years ago that was positive and I did not have a problem with it)
5.  I am so afraid to do anything (of course safe) with anyone including the guy I had met and was dating because I don't want to hurt him in any way as I am afraid since I am not on any type of medicine yet so I might be very contagious.  Main issue in my mind is precum (maybe TMI) .... He was wonderful, sweet and kind, but I pushed him away as I was trying to deal myself and I know he was too but anyway.
6. I would not mind visiting a support group but are there groups that maybe are more a social / chit chat type groups?
7. I will not tell my mom as our roles have started reversing and I am having to start taking care of her in all her financial matters etc as her memory is starting to go.  I am also not close with my brothers and they do not help with mom.
8.  With all the above said...I am not sure I want to hide my HIV status from my friends as I think I can be an example as we all have heard...it only takes one time.  But I also don't want to feel like I did when in the closet in my early 20's and SO MISERABLE.  I know at some point through someone I meet down the road and I am upfront with about my status, they will know someone I do and it will be out anyway.

I have been very honest in my post and hope I did not say anything to offend anyone.  It just really seems like a load lifted off my shoulders just to put this out there. :-)

I will also be visiting a psychologist tomorrow afternoon just to talk at the suggestion of my ex and best friend.

If you read this far, thank you 

[YellowFever]

Main issue in my mind is precum (maybe TMI) ....

If you thought talking about precum is TMI here, be prepared to receive alot of information from POZ.com

But otherwise, it seems you're coping well with your diagnosis.

The urge to tell someone about being HIV+ is very strong for many of us, especially at the beginning. And while coming out as poz would help with humanizing the disease, it is absolutely vital that you're in a stable psychological state to deal with all the ignorance/stigma that comes along with disclosure. One relative of mine asked if two HIV- gay men having sex could somehow become HIV+. I responded by saying "You can't just rub two sticks together to be poz. It's not like making fire!!"

[kevinazus]

Hey Thomas,

These days it is never too early to start meds. They don't wait for your CD4 count to go down to a certain level anymore. That was the old days.  If you're HIV positive you should start treatment. Maybe you should talk to an HIV or infectious disease specialist instead of your PCP.

Kevin

[Jeff G]

Hey Thomas,

These days it is never too early to start meds. They don't wait for your CD4 count to go down to a certain level anymore. That was the old days.  If you're HIV positive you should start treatment. Maybe you should talk to an HIV or infectious disease specialist instead of your PCP.

Kevin

There are good reasons to wait to start meds sometimes . The OP's lab numbers are stable so it would not be unreasonable to wait for further testing .

The new suggestion to  start meds at diagnosis is not meant to imply that there are not still some valid reason to wait ... one good reason for waiting is taking a little time to psychologically prepare for the commitment or finding the right doctor to work with .   

[kevinazus]

While there certainly may be reasons why someone who is HIV positive could or should delay treatment, specifically if they are not ready to commit to lifelong treatment, if they are psychologically unable to adhere to treatment, or if they do not have access to competent medical care or medications.  However, the fact that your test results were "pretty good" definitely does NOT mean that it is too early for you to start meds, as your PCP seems to be suggesting.

Current National Institutes of Health Guidelines for HIV positive patients in the United States recommend beginning ART immediately after diagnosis regardless of CD4 count or viral load.  (This obviously includes preparing yourself emotionally, finding an HIV specialist with whom you're comfortable, getting resistance testing, as well as CBC, Chem Screening, CBC, etc.)

Here is a link to the most recently updated NIH Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents, which you can read for yourself:
aidsinfo.nih.gov/guidelines

The guidelines say that,

"Antiretroviral Therapy (ART) is recommended for all HIV-infected individuals to reduce the risk of disease progression."

"ART is also recommended for HIV-infected individuals for the prevention of transmission of HIV."

"Patients starting ART should be willing and able to commit to treatment and understand the benefits and risks of therapy and the importance of adherence.  Patients may choose to postpone therapy, and providers, on a case-by-case basis, may elect to defer therapy on the basis of clinical and/or psychosocial factors."

(These factors do not seem to include having a pretty good CD4 count and viral load.)

Here's another relevant quote from the NIH Guidelines:

"Effects of ART on HIV-Related Morbidity

HIV associated immune deficiency, the direct effects of HIV on end organs, and the indirect effects of HIV-associated inflammation on these organs all most likely contribute to HIV-related morbidity and mortality.  In general, the available data demonstrate that

• Untreated HIV infection may have detrimental effects at all stages of infection,
• Earlier treatment may prevent the damage associated with HIV replication during early stages of infection,
• ART is beneficial even when initiated later in infection; however, later therapy may not repair damage associated with viral replication that occurred during early stages of infection, and
  
• Sustaining viral suppression and maintaining higher CD4 count, mostly as a result of effective combination ART, may delay, prevent, or reverse some non-AIDS-defining complications, such as HIV-associated kidney disease, liver disease, CVD, neurologic complications, and malignancies, as discussed below..."
  

Dr. Joel Gallant, a world-renowned HIV specialist (who also helped author the NIH Guidelines) has written a book titled, 100 Questions & Answers About HIV and AIDS,Second Edition.  In the book (page 45) he says, "If your CD4 count is over 500, you should strongly consider starting treatment.  It's not urgent because your risk of most HIV-related complications is low, but there may be other long-term complications that can be prevented by starting ART now, and ART will help you to avoid infecting others."  He also says, (page 46) "There are only two groups of people that I advise not to start treatment:  elite controllers (people whose viral loads are undetectable without treatment), provided they have normal and stable CD4 counts, and those who aren't ready, committed, or capable of adhering to therapy."

So, in short, in the absence of some emotional or psychological problems preventing you from committing to and adhering to treatment, there is certainly is no medical benefit to delaying another three months to get retested, as your PCP recommends, and there may be substantial medical benefits to starting treatment right away.  I stand by my suggestion to seek the advice of an Infectious Disease or HIV Specialist as soon as possible.

Good luck,

Kevin
[/list]

[Joe K]

Hey Thomas,

These days it is never too early to start meds. They don't wait for your CD4 count to go down to a certain level anymore. That was the old days.  If you're HIV positive you should start treatment. Maybe you should talk to an HIV or infectious disease specialist instead of your PCP.

Kevin

So, in short, in the absence of some emotional or psychological problems preventing you from committing to and adhering to treatment, there is certainly is no medical benefit to delaying another three months to get retested, as your PCP recommends, and there may be substantial medical benefits to starting treatment right away.  I stand by my suggestion to seek the advice of an Infectious Disease or HIV Specialist as soon as possible.

Kevin,

The OP has only been poz for a month and he is still adjusting and seeking some help.  He is not asking about starting meds, because he does not have a solid base of numbers to make any decisions yet.  While I understand your view about starting meds immediately, that is not the right decision for everyone and it can be a little overwhelming for a newbie, to be inundated by you, telling him what he needs to do.

Joe

[Theyer]

Hello Thomas , not going to say anything re medicine because you have time to come to your own decision , but I would like to comment on your balance, fairness,general all round sanity during this , the answers will come sadly replaced by probably more questions but that happens wether one has HIV or not . Glad you have dropped into our community though sorry you have had to .

[zach]

hey thomas, sorry about your diagnosis, i know you're deep in it now, but with care you're going to be ok.

i wish i was up to writing more. i wanted to reach out and say there are other members here in atlanta, and no matter where we all live this is a very supportive and non judgmental group. all the emotions you are and will be going through, we've been there man. lean on us all you need

[drewm]

Hey Thomas...

Welcome to the forums! Sounds like you are adjusting to your dx. Sorry you need us but glad you found us  Not much to add from me except I would find an infectious disease doctor to discuss whether you should start meds or not. The decision is ultimately yours but it helps to have as much professional information as possible.

[ATLThomas]

I want to thank everyone that has taken the time to comment.  I honestly am very glad I found this website.  Stupid Question - What does OP mean? I saw that in a few posts and know it was referring to me but have been to lazy to look for the definition.

Kevin and Joe - My PCP is one of the top doctors in Atlanta per ProjectQ for 2013.  He is also gay and does treat a good many HIV patients.  I did talk with him this week about starting medication after the points you both brought up.  Needless to say I am fine with what we discussed this week about my treatment.   Thank you both again. 

YellowFever - Your response to your relative is priceless, two sticks together.

Theyer - I think a lot of my balance has to do with my personality.  My first week was a blur. Going through the motions of working, crying at the drop of a hat, just wanting to hide at home in bed under the covers.  But Saturday I made the decision, I am alive, healthy and there are a lot of people worse off than me.  That day I started living again.  Still have moments but everyone does HIV or not.  It has made me realize, that you see people everywhere and no one has a clue what others might be going through / dealing with.  I have found a little more compassion and patience in dealing with people because I wonder, are they going through something too 

Zach - Thank you for the support.  I do hope to meet some other people in Atlanta that I can hang out with just to be able to talk with and let my guard down. The Psychologist I met with the other day has some groups she wanted to gather a little more information on for our next appointment. Support groups that I told her I would be more interested in.  I did not know but she use to work with AidAtlanta several years ago.

Drewm - Thank you and am very glad I found you guys too and yes I am adjusting.  I think with the help of you and the others that have been kind to post I will be ok.

Time to get ready for work ... Today is Friday and in about 12 hours, I see a big Dirty Martini in my future 

[Theyer]

I have been a forum member for about 5 years and have no idea what OP is. Nor for that matter what is a Dirty Martini , I am all ways asking for clarifications or translations from American to  Brit , cultural references , mistook College Basket Ball for Bridge this week.

[Jeff G]

I have been a forum member for about 5 years and have no idea what OP is. Nor for that matter what is a Dirty Martini , I am all ways asking for clarifications or translations from American to  Brit , cultural references , mistook College Basket Ball for Bridge this week.

OP stands for Original Poster ... a dirty martini is vodka and dash of vermouth shaken or stirred over ice with olive juice, some use gin . 

[wolfter]

Welcome Thomas, you appear to be handling this pretty well.  The entire disclosure thing (IMHO) is one of the most difficult aspects of this ordeal.  I usually suggest people wait until they've had adequate time to digest it all. 

Best of luck
wolfie

[Theyer]

OP stands for Original Poster ... a dirty martini is vodka and dash of vermouth shaken or stirred over ice with olive juice, some use gin .

Olive juice? Confussed is this the liquid olive,s are kept in , the brine ?

Though now feel very switched on knowing what OP is.

You are  the font of knowledge and I thank you.

[Jeff G]

Olive juice? Confussed is this the liquid olive,s are kept in , the brine ?

Though now feel very switched on knowing what OP is.

You are  the font of knowledge and I thank you.

Yes ... its the olive brine . I cant claim to be a font, more of a teat of trivia . 

[mitch777]

mistook College Basket Ball for Bridge this week.

Now I am feeling just awful. Bridge? 

Welcome to the forums Thomas!

[Joe K]

Thomas,

I believe you will do fine, as you show more presence of mind, after only one month of being poz, than some folks do after decades of being poz.  Your list is spot on and many of those issues will resolve themselves over time.  What I would offer is to realize that adjusting to being poz is a journey and not a destination.

There is no right or wrong way to adjust to being poz.  All that really matters is for you to find a way to adjust that meets your needs.  What I can tell you, is not to underestimate the power of love and that people who truly love you, are far more resilient than you may realize.  While HIV is not cancer, the fact remains that you have a serious disease and nobody, who truly cares about you, will turn you away.  If they do, they are not people that you need in your life.

I also suggest you realize that there are many things that are simply beyond your control.  Learn to identify those areas so you do not waste your time try to change what you cannot change.  Then you will have the energy to work at changing those things you can.  Be kind to yourself and that includes your body, mind and spirit.

Lastly, do something everyday, even if only for 15 minutes that you truly love... to remind yourself that you matter.  You have done nothing wrong, nor are you "damaged goods".  Fortunately, a day will come when you believe that as well.  All it takes is time and right now, you have all the time in the world.

Joe