A Telling Tale of Trick or Treat: Remember to Spit, Don't Swallow!
By Bob Frascino, M.D.
October 20, 2010
Earlier today I noticed a preponderance of pumpkins, Costco-sized bags chock-full of small boxes of Milk Duds and other dental cavity inducers, and munchkin-sized costumes fit for either a mini Lady Gaga or a Tea Party Rally for Christine "I am not a witch" O'Donnell! With my keen sense for the obvious, I realized Halloween (or a GOP takeover of Congress) was fast approaching. Both are scary propositions.
I also quickly realized it was time to shed my full-tilt-boogie procrastination and generate another blog entry. While I fired up my trusty lap-Mac to tippy tap something out and take advantage of my current caffeine-induced craze, a myriad of potential blog topics raced to mind -- Life? Love? Sex? Coffee? . . . Coffee? How did that crop up into the list? Hmm. Well true, I was finishing my third large nonfat vanilla cappuccino of the morning; could it be I have a monkey on my back and his name is Juan Valdez?
A friend just stopped by dribbling his icy frappuccino on my keyboard (thank you very much) and mentioned I seemed "full of PEP" today. Rather than disclose it was my third cappuccino, I made up some nonsense about having added an extra dose of Vitametavegamin to my morning protein shake. As you can probably tell, I was stalling for time to come up with just the right topic for today's missive.
I wiped the sticky icky frap remains from my keyboard as x$%r6&* appeared on the screen. I then reread my last few coherent sentences and noted the words "pep" and "disclose." Hmm. Perhaps I should write about post-exposure prophylaxis (PEP) or maybe HIV-disclosure issues. It is interesting I chose to make a lame joke about my peppy deportment rather than to "disclose" that excessive consumption of caffeine was the true cause of my zippy-dippy demeanor.
Disclosure of any secret is seldom easy and HIV status disclosure can be incredibly difficult, especially when dealing with a potential new trick -- or treat! So let's discuss when and exactly how should positively charged individuals disclose their HIV status to their partners?
This issue is complex, because when, where, how and with whom we decide to do the dance with no pants is so wildly variable. There are those who believe disclosure isn't really necessary, as long as you stick to safer sex guidelines before sticking it in. They very reasonably argue that all sexually active consenting adults know (or should know) the risks involved and consequently should be taking all necessary precautions to protect themselves and prevent any chance of HIV transmission, regardless of what their partners say -- or don't say -- about their HIV status.
There are also situations of anonymous "cum-and-go" sex in back rooms, dark alley ways, sex clubs or saunas where the wham-bam-thank-you-sam occurs before a "how do you do." A detailed exchange of medical information isn't really a viable or realistic option for a gaggle of horned-up hotties in a jacuzzi. Hopefully those participating in these casual sex-a-thons realize the increased level of risk and take appropriate precautions against STDs, including HIV.
Disclosure becomes more of an issue when an HIVer is starting a new relationship. Some virally enhanced folks choose to serosort (date only other HIV-positive partners). Sure, this may simplify things somewhat; however, it sure can decrease your chances of a great date on a lonely Saturday night. Besides, serosorting just isn't a feasible option for everyone.
So why is disclosure such a bugaboo anyhoo? First of all, revealing one's positively charged status is often an immediate deal breaker for impending nookie. And, let's face it, none of us enjoys rejection or being looked at as if one's touch was toxic. Also, there are plenty of cases where this sensitive private information has been leaked or shared by a loose-lipped or malicious "ex."
Consequently, many poz folks, even those with the best intentions, may choose to delay disclosure until mutual trust and affection are established. This tactic, however, can be a double-edged sword because the longer one waits to disclose, the more likely it is the new partner will feel betrayed, particularly if the relationship has progressed to the horizontal mattress mambo stage.
It's important to realize that being virally enhanced doesn't mean you can't or shouldn't have mind-blowing fusion sex, but it does complicate the logistics, as we need to be continually cognizant of protecting our partners and we need to deal with the potential negative consequences of having our HIV status revealed.
One last note, about rejection: If someone dumps you because you are HIV positive, he is rejecting the virus, not you! Buddha was once asked how to brave his critics' insults and anger. Buddha replied, "If someone offers you a gift and you decline to accept it, to whom does the gift belong?" Buddha was one wise and insightful dude! To rephrase his advice in a less contemplative fashion: If someone blows a load of rejection your way because you are poz, just spit, don't swallow!
Life, Love, Sex, HIV and Other Unscheduled Events
Bob Frascino, M.D., was President and Founder of The Robert James Frascino AIDS Foundation. He had been an outspoken, popular expert in TheBody.com's "Ask the Experts" forums on safe sex and fatigue/anemia since 2000. Once a Fellow of the American Academy of Allergy, Asthma, and Immunology, and the American Academy of Pediatrics, Dr. Frascino served as Associate Clinical Professor of Medicine, Division of Immunology, Rheumatology, and Allergy, at Stanford University Medical Center from 1983 until 2001. He was a member of the American Academy of HIV Medicine and had also been a distinguished member of the executive boards of numerous state and regional associations.
We're inexpressibly saddened to share the news that Dr. Frascino passed away unexpectedly on Saturday, Sept. 17, 2011. Click here to read more and to share your thoughts.
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