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sex work and various questions
Sep 26, 2006

Hi there,

These may be unusual questions in this community, but i'm been reading stuff for a few hours only and i feel so much better.

I'm 20yo, italian, been living in london for the last two years and i'm been tested positive a couple of days ago.

Needless to say, my boyfriend (25yo, english) went for a test straight after me, and we both knew what was gonna come out as we never used a condom (assholes i know, but don't give me that shit. you sure know we only realize when it's too late)

We split up though a few weeks ago for other reasons.

We are (or were?) both porn actors and escorts. We never done bareback with clients, but we did do it in porn. We stupidly thought that it wasn't much of a risk as we where all getting tested very often. Note about this: my last test was in june. I know this doesn't make sense, but trust, i just don't know how it slipped away, why i didn't get my test every month as we were supposed to do, and i don't how the producer, my ex and everybody else who was supposed to check on it just seemed to have ignored it. I jusr don't know. It would probably have saved him, but there's just so much uncertainity that i gave up thinking about it.

3 weeks ago he had a terrible week, he had all the symptoms i can (now) relate to seroconversion. I never had symptoms. I'm always been told i have a very strong immune system.

He got tested after that, and everything was negative, apart from Clamidya and Herpes.

I have loads of questions, i'm gonna try to put them with a kind of priority grade.

1. He wants to find out where he got it from. He wants to sue that person in case he did it intentionally and he doesn't trust me 100%, he thinks that maybe i gave it to him intentionally to try and save our relationship. We know each other quite well, and he knows i wouldn't give this shit to anyone, let alone him. At first i didn't agree with that, the last thing i want is someone to hate for that. I think i would do something very stupid, and i don't need anymore troubles now. But at this point, although he seemed to start to trust me, i would do anything to let him change mind. I still love him so much, to the extent that until today, i'm been worrying about him only, never taking care of myself (stupid too, but love is like drugs innit?) What can you tell me about that? Is there a chance we got it from other actors (wheter they knew or not) or from unsafe oral sex with clients (we never had cum in our mouths and stuff)? Also, my previous boyfriend was positive, but we've always been extracareful. In the last few months of our relationship we didn't have much sex though, if any, and also, he had been on treatment for a while and had an undetectable viral load. I understand he's angry now and maybe wants to sort of shut a door, knowing whose fault it is.

2. The general questions, like life expectancy and stuff. I thought that there are some people who managed to live for like 25 years, and 25 years ago things were well different, so it must be better now isn't it? I'm also sure that we'll have fought HIV very soon. Hope it's all i got left now.

3. I wasn't quite sure about my future, career-wise, but day by day i'm more convinced that i wanna work in this field, helping out people and at the same time being up to date so i can take better care of us. Helping people it's the only thing i enjoy. I help everybody around me and that's how i 'justify' what i do for a living at the moment. There might be a downside about this 'obsessively being helping people out' since i was very little. Am i doing it just because I'm scared? Maybe the moment i will run out of people to help, i will have to face nothing but myself and i won't be able to cope with it? Does any of you know how do i go about it in London?

4. I really like what i'm doing (i really do, i'm not just some fucked up kid who likes easy money.. it aien't that easy by the way :p..i have a day job too in customer service). I just had a call from some producer who wants me for a shoot next week and i really don't know what to do. I mean i know what i'm gonna do, but i want your opinion. sure i'm gonna tell him, try to make him keep it confidential, i wouldn't give this shit to anyone, but on the other hand, people workin in the sex industry and technically everyone else takes this risk, practicing unsafe oral sex (i'm been doing this for a while now and i've never come across anyone who wanted to use a condom for that). so what do you think? i'm just scared that this man is gonna like shout it out to everyone and i will have to forget about porn for ever.

well this is it for the moment. Thanks for any help in advance. I'll keep on reading stuff of course, I'm feeling very good now and... wish us good luck!!

A.

Response from Dr. Wohl

Pretty heavy stuff.

Where he got it form: It is difficult to say where your partner acquired his HIV infection. Given his symptoms three weeks ago were, as you point out, consistent with acute HIV infection, anyone he had sex with in the prior month is a possible source. There is no way to 'prove' it was a particular individual unless he finds out that everyone else he had sex with is HIV negative except for you.

Oral sex has been reported to transmit HIV but it seems like a pretty inefficient method for transfer of the virus. It is not impossible, but unlikely.

Prognosis: You are correct, things have changed and life expectancy *with good care and treatment* is excellent. People who take care of themselves can live decades. Finding out your CD4 cell count and viral load and following up regularly with an excellent HIV doctor will help you grow old and gray.

Your line of work: You say you like the sex work you are doing but maybe this is the time to consider retirement and re-focus your desire to help others in another direction. I suspect you can find ways to be of even greater help to those in need and your clinic may even have some ideas.

From now on, you should use condoms during sex to avoid transmitting HIV to others and to prevent acquiring a new sexually transmitted infection (or even possibly another strain of HIV). You can make your own educated choices about oral sex given the real but low risk. In addition, I know you realize that anyone you have sex with (even oral sex) should be made aware of your HIV status. So, it really is not just the producer but the actors and clients who, I think ethically, should be informed.

Someone today said that HIV was a turning point in their life. It was horrible to hear but it put him on a path that has proved natural for him as he helps educate others and advocates for getting people to get tested. Perhaps for you too, this unfortunate event can have a sliver lining and lead you to the helping work you have long wanted to do.

DW



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