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This Positive Life: An Interview With James Nicacio

September 15, 2011

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When James Nicacio was diagnosed with HIV in 2001, he was "in the prime" of an addiction to crystal methamphetamine. "At that time, I just decided that if I have HIV and I'm going to die, I might as well just keep partying," he remembers. "I didn't tell anybody about it, and I continued ... keeping my feelings and emotions inside." Once he went into recovery and started taking care of his health, James found his passion in HIV volunteer work -- on the policy side as well as direct service. Now he's got a paying position at the same organization where he first sought help for his addiction. "I definitely do it because I want stigma to be eradicated," James says; "I want it to be normal for somebody to live with HIV. I want it to be socially acceptable and OK." In this interview, James recounts his journey from drug abuse and denial to full acceptance of his HIV status -- and full support from his loved ones.

James Nicacio

James Nicacio

How did you find out that you are HIV positive?

It was Oct. 23, 2001. I was hospitalized with a swollen lymph node in my neck. Overnight, it was growing so fast that I had to go into the emergency room; it was blocking my airway.

Between the surgery and recovery, I was in the hospital for about a week. While I was in there, they performed many tests to find out what was really the cause of the infection. As I was being discharged from the hospital, and I was actually being wheeled out, the doctor asked to wheel me back in. He told me that I had tested positive for HIV and that I should seek treatment. He gave me the business card of a local doctor to go to.

I wasn't really surprised, because of the lifestyle I was leading. I was addicted to crystal methamphetamine and I wasn't really caring for myself at that time. I knew that I had been putting myself in some risky situations. At the time, I was just consumed with my drug addiction.

When I found out that I was HIV positive, I just tried to block it out. I was devastated, but I kept it to myself. I was in denial for so long. I just figured, I finally have it, but if I don't think about it, it's going to go away. I was masking my feelings with my drug addiction.


What was it that put you at risk for HIV?

I think what put me at risk was the fact that I was sleeping around and having unprotected sex with people; I didn't know if they were HIV positive, but I knew that some of their friends were, and that they had slept with those friends. At that time, I cared more about doing drugs and having sex than thinking I could catch a deadly disease from somebody. I had no direction in life, and I had no sense of self-worth. I really didn't care if I got HIV or not.

Had you been using drugs for a long time before your diagnosis?

I'd been using drugs since I was in my early 20s. I experimented with all kinds of drugs: ecstasy, crystal meth, marijuana, alcohol; you name it. If it was out there, I would probably do it. I was caught up in that indie, club lifestyle of doing drugs and going clubbing, going dancing. That was really what my whole early 20s was all about. That drug addiction was always with me until about six years ago. Six years ago -- going on seven years -- I put myself into rehabilitation.

When I was first told that I was HIV positive, that's when I was in the prime of my drug addiction, you could say, I was getting carried away and being really careless. Drugs were the most important thing to me. I allowed it to interfere with my personal life. I let it block out my relationships with my family. I let it overtake me to the point where I lost jobs. I got into a heavy depression because of it, because I no longer had those relationships with family, with friends.

At that time, I just decided that if I have HIV and I'm going to die, I might as well just keep partying. I might as well go out with a bang, you could say. I didn't tell anybody about it, and I continued using crystal meth, and partying, and keeping my feelings and emotions inside. I did that for so long, and it got really, really bad.

I was an injection drug user, and I remember my family finding my needles lying around. I remember my sister, in particular, telling me that if I was going to be using drugs and having paraphernalia lying around like that, that I could not be around her family, because I would be putting her children in jeopardy. What if they poked themselves with a needle? What are the questions they're going to have about why I'm bringing drugs around the house? They basically told me, "You cannot be part of our family anymore unless you get help for your addiction."

Once I did that and got into my drug treatment program and started taking care of myself, all the emotions of being HIV positive started surfacing. I was thinking about my mortality and what life was going to be like living with HIV. I was able to work through my problems with my counselors. I was able to talk about what life was going to be like for me. When I was in the treatment facility, I also started my HIV med regimen. I got into the habit of taking my medications at the same time every day. It was a blessing that I was able to do that.

What was the first thing you did that helped you come to terms with your HIV diagnosis?

The first thing I did was, basically, to try and take care of my health. For me, that was my mental health, putting myself into the rehabilitation facility. Once I was able to get clean and get sober, I could think clearly; I could look at my life and reevaluate it and find out that I did have some goals, and get some direction in my life back.

I was able to regain the trust and honesty between me and my family, which has been my greatest support system. When I was first diagnosed, I didn't tell my family for three years. Actually, I didn't tell anybody that I was HIV positive for three years. I just lived in denial and in that drug-induced state. It took me a while, but I got back on the right page.

Who was the first person you told about your diagnosis?

I'm not sure. I know my biggest fear was telling my mother. My mother and my sister have been so close to me. They always want the best for me, so it was really difficult for me to tell them. I felt like, in some way, I was letting them down -- taking life for granted, in a way. Here I am trying to tell my mother -- the person who gave me life -- that, because of some of the bad choices and mistakes I made in the past, my life might be taken. But when I did tell them, it felt like a big relief.

They were the only people that I really cared about telling. I didn't mind if anyone else knew, but I really cared that my family knew. When I did tell them, they said that they loved me no matter what and that they were going to support me, and give me every opportunity to take care of myself. Once I knew I had their support, then I could move forward.

Do you remember how you started that conversation with your sister and your mother?

I remember my sisters crying. I'm sure that they were very afraid for me. We didn't know anything about HIV other than what was said in the media: that once people get HIV, they get AIDS and they die. I remember them being really sad and really afraid, but I don't remember exactly what was said in the conversation, or how it started.

How are your relationships with your mother and your sisters now?

My relationship is wonderful with them. It's kind of weird to say, but since I've been diagnosed with HIV, my life has become so much better than it ever was before. Today, I'm able to live a clean, sober life. I have direction and I have the love and support of my family. They're very accepting and encouraging. I'm really blessed to have them in my life, to have such a great support system. I think, because of them, I am where I am today.

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