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This Positive Life: An Interview With James Nicacio

September 15, 2011

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How has your Mexican heritage affected your experience as a gay man?

There's that machismo attitude that goes on in Mexican families. It's really not talked about. Being a gay man and being out is probably looked down upon by some people in our Mexican culture. I've always been one to not care what other people think. I lead my life the way I want. But, at the same time, it's not discussed too much. That's probably pretty common in a lot of Mexican families. My mom is very accepting of me and all the decisions I make. She's accepted the fact that I'm gay, but it's something that was really never talked about. It hasn't affected me in the sense that it hasn't suppressed the way I am. I am who I am and I'm out.

HIV, for me, is totally different. I've decided to go public with my HIV status, because I'd like HIV to be socially acceptable. I myself go above and beyond letting people know about my HIV status. I spoke at World AIDS Day locally in our community. I went to a national conference for teens to speak about what life is like living with HIV. I'm not too reserved about letting people know about my HIV status, because I think people can learn from my experience that life is still livable with HIV.

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Is your community and your extended family as supportive of your HIV status, and your openness about it, as your mother and sisters are?

I would say my community is. I've never done any public speaking in Selma, the small town in California where I'm from. I know there are a few people living here with HIV. I get my treatment in Fresno, which is about 20 miles north of the town that I live in. The city of Fresno is where I do most of my volunteering. I'm supported there by all the local agencies. I'm supported there through my health care providers.

What has your health been like since your diagnosis?

When I went to University Medical Center's Community Special Services and asked them for help to quit my drug addiction, my counts were really low. I had also been diagnosed with Kaposi's sarcoma.

I was more scared about being told I had an HIV-related cancer than I was of being told I had HIV. I didn't know what to expect. I didn't know what it meant. I was treated for my Kaposi's sarcoma with chemotherapy. At that time, I didn't realize how bad my health had gotten, but they put me on a drug regimen. Since then, my viral load has been undetectable. I've been undetectable for six years. The chemotherapy has allowed my Kaposi's sarcoma to stay in remission.

What's the lowest number your CD4 count reached?

The lowest, I believe, was about 112.

Do you know your CD4 count now?

It's about 640.

Have you been happy with the health care you've received? How did you find your HIV specialist?

I've been really happy with my health care. When I was trying to seek treatment for my mental health, I was referred to the special services department, which is Community Special Services in Fresno. It was they who helped me educate myself. They've since hired me as a consumer advocate for their organization. I've been able to go to different conferences and trainings, to really educate myself. In turn, doing the volunteering, I'm able to help educate others. They've really helped me flourish and be the person that I am today by giving me some really great opportunities. I want to give them the recognition they deserve for helping not only me, but many other people to do the same.

It was while I was going through chemotherapy that I started getting involved with the local volunteer groups in Fresno: the Community Advisory Board; the local implementation group, which is now called the Community Action Council. At that time, I was staying home and trying to take care of my health, yet I felt like I needed to do something with my life. Community Special Services asked me if I would like to attend some of their groups, as an outlet to get out of the house and try and help myself out.

I just enjoyed what I was doing and learning. I kept moving forward through the chemotherapy and realized this was something positive I could do with my life.

What HIV medications are you taking right now?

I take Atripla [efavirenz/tenofovir/FTC]. Prior to Atripla, I was taking Kaletra [lopinavir/ritonavir] and Combivir [AZT/3TC] along with Bactrim [co-trimoxazole]. While I was taking Kaletra and Combivir, my cholesterol levels elevated. I guess that's one of the side effects that you get from some of the medicines. They put me on cholesterol-lowering medicine. Since I switched to Atripla, which is a lot easier to take, my cholesterol has dropped to almost a normal level. The side effects have been bearable. I'm really happy with the regimen that I have now.

Do you do anything else to keep healthy, such as exercise or a special diet?

I gained a lot of weight, which is kind of strange. Usually, when you go through chemotherapy, you don't gain weight. You lose weight. But I gained weight; at my heaviest, I think I weighed about 234 pounds.

I changed my diet, and I joined the Central Valley's Greatest Loser competition in 2008 -- a fundraising competition to see who can lose the most weight. It's a lifestyle change I needed to do in order to get my health into the best shape it can be in. I'm down to about 185 pounds now. I was really adamant about getting my weight back under control. Weight is still something I work at. I was going to the gym every morning for quite some time, though I haven't in the past six months.

How did you deal with sex after you were diagnosed?

I practiced abstinence for the first five years after I started taking care of my health. I was in a relationship for about six months last year. It didn't work out, and I learned from it that I would like to have a relationship; he just wasn't the right person.

Right now, I'm single and not sexually active, but it's something I'm working on. I'm seeing a psychologist to talk through some of my own personal issues. I'm back to focusing on me again -- trying to find myself, my true, happy self, and figure out what I really want out of a relationship.

When I meet and talk to people, my HIV status is something I'm very comfortable disclosing right away. When I was in a relationship, it happened to be with another HIV-positive person; but even going out and meeting other guys, as soon as I think there might be a connection of some sort, it's one of the first things that I disclose. I think it's very important that they be aware of who I am as a person and what I'm living with, so they can make that decision themselves.

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