February 2, 2009
Welcome to This Positive Life! Where are you from, Ahmad?
I was born in Modesto, California, but I come from an Arab dad and a Mexican mother.
How long have you known that you were HIV positive?
I found out I was HIV positive on September 28, 2007.
Did you suspect that you were at risk?
Not quite. I didn't suspect that I was positive, but I can remember that I had some fatigue that was one of the symptoms that was happening at the time. Then I was like, "Maybe I should go get tested."
In the short time since his diagnosis, 23-year-old Ahmad has had many ups and downs, but to hear him tell it, many of those life changes have been for the better. Although being gay and HIV positive is frowned upon in the communities of his birth, he's found a supportive community in San Francisco and his diagnosis has inspired him to take better care of his health.
Were you very shocked? Did it take a long time to get used to it?
I'm still getting used to this world of being HIV positive.
Have you told anybody in your family?
I have not disclosed my HIV status or my sexual preference status to my family yet, no. I'm currently working on that.
How are you working on that?
I want to come out to my family at some point, so I'm going to psychological therapy. I'm working with my psychologist to develop a plan that will not jeopardize my communication with my family and will not hurt them, and will not damage me psychologically.
I understand that your mother is in Alaska and your father's in Quebec and you're in San Francisco.
Yes, I am in San Francisco. My mother's in Alaska; my father's in Quebec. I have never actually been with my mom or my dad. I have only seen my mom twice in my life and I have only seen my dad four times in my life.
The reason why I am in San Francisco is because this is the city that I found. It was good for me to start out in a new world with being gay and being HIV positive too.
How did you get through the first few months of being HIV positive?
When I was first diagnosed with HIV, the simple news, "You are positive," was just echoing in my head. I knew it was going to change me.
It changed everything. Perhaps I was taking some things for granted in life and now that I'm HIV positive, I can actually look back and say, "I was doing something wrong. I should appreciate life in a more positive way."
I also had nightmares and I was a little depressed. I'm still learning. I'm still coming out of that conundrum, because it was a complete conundrum for me. I had no education in HIV. At that time, I was thinking, "Oh my God! I'm HIV positive. I'm going to die soon and it's only going to be me by myself." I felt really disgusted and I lost some of my appetite for boys. I didn't want to have any sort of relationship with anyone. I kind of went under my little shell.
How did you find support? Where did you go?
When I tested positive, I went back to my room for a whole week. I talked to one of my friends, who lived in San Francisco, and I said, "Hey, this has just happened and I don't know what to do. I really don't want to be here." He said, "Come to San Francisco. You can move up here because now that you're HIV positive and you're also gay, San Francisco has a lot of resources that will suit your needs."
Right away, within the same day, I moved to San Francisco. The next morning, I went to some of the agencies here, for example, Bay Area Young Positives. It's an agency that has gay, HIV-positive males around my age. There are so many programs in that agency that are actually developed to bring people comfort, education and better understanding of their HIV status.
Where did you move from? Where were you living at the time?
I was going to UCSB [University of California, Santa Barbara]. It's only about five hours south of San Francisco on the Pacific.
Now you're going to a university in San Francisco?
How accepted is it to be HIV positive in your community? Do you live in the Hispanic community, the English-speaking community, the Arab community? Which community do you associate with most at this point?
I was raised Muslim, so I consider myself -- my culture and everything -- more Arab. I want to say I identify -- with my thinking and everything -- more on the Arab side. But right now, I'm pretty much staying neutral.
My Mexican culture does not approve of HIV, or of being homosexual. It's still a stigma for them as well as for the Arabs. Being Muslim and being gay? Wow! It's a big deal, so right now I'm trying to stay with my own.
It sounds like you have two difficult choices there.
Yes, I do. I'm coming to terms with my reality right now. It's like a reality check. It's making me stronger and it's making me more capable of going through life.
I think that now that I'm HIV positive, I'm actually leading a more positive lifestyle because now I'm really careful with what I decide. I think I'm learning how to make the right choices.
You mean in terms of what you eat and stuff life that?
Yes. So much starts from nutrition. It's an overall thing because HIV affects the immune system. If you're a fat person, it can also play a role in your immune system.
Being positive now, I have to eat healthy. I have to take care of my body even more than I used to before. I've always been a really happy kid, so now I'm trying to also stay as happy as I can. The happier you are, the better your health will be.
Being positive, to me, is that you're positive from the inside, so you're positive all over. Now it's like I have to live a happy lifestyle -- a good, comfortable lifestyle. I have to take care of myself more than ever, now that my immune system is compromised.
When you were first diagnosed, did you need to start treatment?
No. At that time, they told me I could start. Like I said, I started making decisions right then. I decided not to take medication until I thought it was more necessary.
Are you on medication now?
Yes I am.
What are you taking?
TMC125 [Intelence, etravirine]? You're in a clinical trial? This is not a typical regimen for someone who has never been on HIV treatment before. Why did you decide to go on a clinical trial?
I had an option of taking Atripla [efavirenz/tenofovir/FTC]. Atripla is a combination of Truvada and Sustiva [efavirenz, Stocrin]. Then I came across a flyer that said that there was a clinical trial with this particular medication -- I saw Truvada there as one of the main ingredients. Then I saw TMC125, which wasn't yet approved. I felt as if the research study was saying to me, "Hey, this could be a great medication to be on the market, but we need your help in order to make sure that it will be beneficial for other HIV-positive people."
I said, "OK, I'm going to be part of this research."
That's great! Did you have a problem with insurance or could you get medications free? What's your circumstance in terms of paying for medication?
This is another reason why I moved to San Francisco. San Francisco has this wonderful program called ADAP [AIDS Drug Assistance Program]. I have no income because I don't work -- I'm only studying. What I have to do is, for example, when the medical research is over, if I decide not to go with that medication, I can just simply go to the ADAP agency. I do an intake with them and they will put me on the scale. Since I have no income, they will give me the medication at no cost.
Yes, it's wonderful. San Francisco is a beautiful city because it has all these resources.
Are you stable in terms of your meds? Has your CD4 count gone up since you started your meds?
Yes. My CD4 count went up. My CD4 percentage also went up, which is a really good thing. Before I took the medication, my viral load was around 11,000, which is still considered low; but thanks to this medication and being part of the research, the benefit was that my viral load became undetectable.
Have you had any side effects?
One of the side effects that I have noticed is energy level, at first. I started in February 2008, so it has not yet been that long. Depending on what time of day I take the medication and what I eat with the medication, my energy levels sometimes are really, really energetic. Sometimes I am not that energetic. It's just a matter of getting used to it, I guess.
Who was the first person you told you were HIV positive?
The first person I told I was positive was my best friend Ramsey, who lives in San Francisco and who is the one that extended his hand to me and said, "Look, I live in San Francisco. San Francisco has these great agencies and great programs for gay and HIV-positive people, so you're more than welcome to come over." He was the first guy I told.
It turned out well. He was the right person. You picked the right person.
Exactly! I've known my friend for five years and I told him, "You're like my little angel," you know?
In Islam, we believe that if you're a true Muslim, God takes care of your problems before they come to you. It's funny because I've known my friend for five years, and I tell him, "When I met you, I met you for a reason, because God knew what was going to happen, so he put you there as my little angel."
What do you advise others to do about disclosing their status? Some people are afraid to tell anybody. They don't know how to pick somebody to tell.
Yes, I went through that situation too. I think being HIV positive is very sensitive, you know. It's a very sensitive topic, issue, whatever you want to call it. It's a chronic illness and it should be treated sensitively. You don't want to give those people who have a stigma a reason to push you away or whatever, but I think when you're positive you're like, "I need support. I feel lonely," because that happened to me.
When I tested HIV positive I felt lonely and deserted. I felt really bad inside. There was this pain that wouldn't go away. It was this permanent pain in my heart that was making me so sad, making me so depressed. Within the same week of me being diagnosed, I was like, "I need to tell someone. I cannot handle this on my own."
If you have a true friend, I think your mind, your instinct, will tell you, "I strongly believe this is the right person that I can talk to."
I thought about it, and there really would have been no negative outcome if I were to tell Ramsey, because throughout the five years that I've known him, he's been an excellent, excellent friend. Automatically, when I thought about telling someone because I needed someone's support, he was the first person who popped into my head.
I only had positive outcomes by telling him. When I analyzed the situation, I had more positive outcomes than negative outcomes. That's pretty much how I did it.
What advice would you give to someone who was recently diagnosed with HIV? Now that you've gone through getting used to it -- finding someone to tell, joining a support group, finding a doctor -- what would you tell somebody who just found out today?
If someone comes to me and tells me, "I'm HIV positive," I would say, "How are you feeling? What's in your head right now?" When you get tested, and when you test HIV positive, all that's in your head is a conundrum with a huge question mark. You have no answers. You have many questions, but you still cannot understand what those questions are, and you have no answers. That's how I felt.
I would say to that person, "Hey, I'm HIV positive too. This is a new beginning. It's not as bad as you think it is. Here's my number, my e-mail. Please do not hesitate: If you need anything, call me and I will do whatever I can to fulfill your request.
"In the meantime, I'm going to tell you a little bit about my life story. I'm going to tell you what agencies I went through. Give me the opportunity to talk about my experience from day one, which is being recently diagnosed, until right now. I hope by my telling you my story, you will find some answers."
I don't think anything works out better than when you have an HIV-positive person who just barely found out they were positive today and you talk to them about your story. That would be the best help I could ever give to anyone.
That sounds great! Thank you so much.
This transcript has been lightly edited for clarity.
You may e-mail Ahmad Salcido at email@example.com.